Individual
DR. GAGANDEEP SINGH GREWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 296-2090
(601) 296-2089
Mailing address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 296-2090
(601) 296-2089
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10170
MS
207R00000X
Internal Medicine Physician
Primary
23236
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01888564
—
MS
Enumeration date
06/29/2011
Last updated
10/08/2020
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