Provider Demographics
NPI:1821515958
Name:MASHIANA, SIMRAN SEKHON
Entity type:Individual
Prefix:
First Name:SIMRAN
Middle Name:SEKHON
Last Name:MASHIANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745344
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-5344
Mailing Address - Country:US
Mailing Address - Phone:804-483-5140
Mailing Address - Fax:804-483-5141
Practice Address - Street 1:1401 JOHNSTON WILLIS DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4730
Practice Address - Country:US
Practice Address - Phone:804-483-5140
Practice Address - Fax:804-483-5141
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101275194207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology