| Malwinder Sidhu Md Pc | |
|
7455 W Washington Ave Ste 275 Las Vegas NV 89128-4337 | |
| (702) 228-4006 | |
| (702) 228-0066 |
| Full Name | Malwinder Sidhu Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7455 W Washington Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Malwinder Sidhu (OWNER) |
| Authorized Official Contact | 7027983008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Malwinder Sidhu Md Pc Po Box 36396 Las Vegas NV 89133-6396 Ph: (702) 228-4006 | Malwinder Sidhu Md Pc 7455 W Washington Ave Ste 275 Las Vegas NV 89128-4337 Ph: (702) 228-4006 |
| NPI Number | 1407903578 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 07/15/2010 |
| Medicare PECOS PAC ID | 8426149337 |
|---|---|
| Medicare Enrollment ID | O20070807000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407903578 | NPI | - | NPPES |
| 1720189095 | Other | NV | IND NPI |
| V104162 | Other | NV | GROUP PTAN |
| 11493 | Other | NV | MEDICAL LICENSE |
| V104161 | Other | NV | IND PTAN |
| 1720189095 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 11493 (Nevada) | Primary |
| Provider Name | Malwinder Sidhu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720189095 PECOS PAC ID: 6002886728 Enrollment ID: I20070710000841 |
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