Individual
DR. GAGANDEEP RANDHAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5777 W MAPLE RD, SUITE 180, WEST BLOOMFIELD, MI 48322-2267
(248) 539-9084
(248) 539-9088
Mailing address
7225 CARLYLE XING, WEST BLOOMFIELD, MI 48322-3280
(248) 539-9084
(248) 539-9088
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301079646
MI
208000000X
Pediatrics Physician
4301079646
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4945645
—
MI
Enumeration date
11/03/2006
Last updated
04/16/2015
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