Individual
KANWALDEEP SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10765 LANTERN ROAD, SUITE 102, FISHERS, IN 46038-3597
(317) 621-4181
(317) 621-4182
Mailing address
10765 LANTERN ROAD, SUITE 102, FISHERS, IN 46038-3597
(317) 621-4181
(317) 621-4182
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01066327 A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000637200
ANTHEM
IN
01
—
000000684780
ANTHEM
IN
01
—
000000691248
ANTHEM
IN
01
—
000000721380
ANTHEM
IN
05
—
200944150
—
IN
01
—
9676336
AETNA
IN
01
—
P01191777
RR MEDICARE PTAN
IN
Enumeration date
05/17/2007
Last updated
10/15/2022
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