Organization
MALWINDER SIDHU MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALWINDER SIDHU MD (OWNER)
(702) 798-3008
Entity
Organization
Contact information
Practice address
7455 W WASHINGTON AVE, STE 275, LAS VEGAS, NV 89128-4337
(702) 228-4006
(702) 228-0066
Mailing address
PO BOX 36396, LAS VEGAS, NV 89133-6396
(702) 228-4006
(702) 228-0066
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
11493
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11493
MEDICAL LICENSE
NV
01
—
1720189095
IND NPI
NV
05
—
1720189095
—
NV
01
—
V104161
IND PTAN
NV
01
—
V104162
GROUP PTAN
NV
Enumeration date
01/04/2007
Last updated
07/15/2010
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