# GAGANDEEP RANDHAWA, M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083792303
- **Authorized official:** AJITPAL RANDHAWA (SECRETARY)
- **Authorized official phone:** (248) 539-9084

## Contact information

- **Practice address:** 5777 W MAPLE RD, SUITE 180, WEST BLOOMFIELD, MI 48322-2267
- **Practice address phone:** (248) 539-9084
- **Practice address fax:** (248) 539-9088
- **Mailing address:** 7225 CARLYLE XING, WEST BLOOMFIELD, MI 48322-3280
- **Mailing address phone:** (248) 539-9084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 04/16/2015