Individual
KIRAN JEET SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
790 W 66TH ST, RICHFIELD, MN 55423-2203
(612) 873-6963
Mailing address
790 W 66TH ST, RICHFIELD, MN 55423-2203
(612) 873-6963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
68908
MN
207Q00000X
Family Medicine Physician
S8654
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2017
Last updated
03/07/2024
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