Provider Demographics
NPI:1043744683
Name:GREWAL, JAPJOT SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:JAPJOT
Middle Name:SINGH
Last Name:GREWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:SINGH
Other - Last Name:GREWAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:13597 55A AVE
Mailing Address - Street 2:
Mailing Address - City:SURREY
Mailing Address - State:BC
Mailing Address - Zip Code:V3X 3B5
Mailing Address - Country:CA
Mailing Address - Phone:312-752-8051
Mailing Address - Fax:
Practice Address - Street 1:835 E FAIRHAVEN AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-1916
Practice Address - Country:US
Practice Address - Phone:360-856-7960
Practice Address - Fax:360-788-1405
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD61486308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program