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Individual

DR. MANDIP S ATWAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1030 HARRINGTON ST, 302A, MOUNT CLEMENS, MI 48043-2967
(586) 759-2005
(586) 759-2636
Mailing address
1030 HARRINGTON ST, SUITE 302A, MOUNT CLEMENS, MI 48043-2967
(586) 759-2005
(586) 759-2636

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MA012641
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0255004485
BCBS PIN
MI
01
0255010915
BCBS
MI
05
114528179
MI
Enumeration date
01/23/2006
Last updated
05/26/2015
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