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Individual

DR. BALBIR SIDHU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
8100 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-5622
(703) 331-0300
(703) 331-0254
Mailing address
8100 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-5622
(703) 331-0300
(703) 331-0254

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101047068
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5810507
VA
01
C06380
MEDICARE OF VA PTAN
VA
01
G00773
MEDICARE OF DC PTAN
DC
Enumeration date
07/14/2005
Last updated
06/20/2013
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