Provider Demographics
NPI:1043267628
Name:KAUR SIDHU, GURINDERJIT (MD)
Entity type:Individual
Prefix:
First Name:GURINDERJIT
Middle Name:
Last Name:KAUR SIDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1709
Mailing Address - Country:US
Mailing Address - Phone:404-419-1140
Mailing Address - Fax:404-419-1164
Practice Address - Street 1:1050 EAGLES LANDING PKWY STE 302
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9250
Practice Address - Country:US
Practice Address - Phone:770-507-0070
Practice Address - Fax:770-507-7463
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035275207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00635214AMedicaid
GAF76391Medicare UPIN
GA83BBBHDMedicare ID - Type Unspecified