Individual
DR. SANDEEP DHALIWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1685 MARS HILL RD NW STE 201, ACWORTH, GA 30101-7180
(770) 485-0031
(678) 903-4137
Mailing address
1685 MARS HILL RD NW STE 201, ACWORTH, GA 30101-7180
(770) 485-0031
(678) 903-4137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
87239
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174292882
ORGANIZATION NPI
—
01
—
1245731298
NPI PROVIDER
GA
01
—
87239
MEDICAL LICENSE
GA
Enumeration date
02/26/2018
Last updated
01/12/2022
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