Provider Demographics
NPI:1952381345
Name:SHERGILL, SYEDA R (MD)
Entity Type:Individual
Prefix:DR
First Name:SYEDA
Middle Name:R
Last Name:SHERGILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3629
Mailing Address - Country:US
Mailing Address - Phone:724-357-7493
Mailing Address - Fax:724-357-6961
Practice Address - Street 1:559 MILLER AVE
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-1746
Practice Address - Country:US
Practice Address - Phone:412-226-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008548400005Medicaid
PA1008548400002Medicaid
PA072698R7RMedicare PIN
PA1008548400002Medicaid
PA072698ZC4DMedicare PIN