Individual
PRINCE JIT SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301066059
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104439598
—
MI
05
—
104871597
—
MI
05
—
104871701
—
MI
01
—
1103910080
BCBS INDIVIDUAL
MI
Enumeration date
05/11/2006
Last updated
11/09/2023
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