Individual
BALJIT S SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4710 PUDDLEDOCK RD, SUITE 100, PRINCE GEORGE, VA 23875-1237
(804) 732-0095
(804) 732-0055
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
0101031126
VA
207X00000X
Orthopaedic Surgery Physician
Primary
0101031126
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006408729
—
VA
01
—
1073580221
MEDICARE RAILROAD
VA
Enumeration date
03/07/2006
Last updated
12/05/2013
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