Individual provider Active NPI

Gurdial Dhillon, M.D.

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
National Provider Identifier
1578904504
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD2017-0292 Issued in NM
Practice address
245 N 15TH St # Ms 495
Philadelphia, PA 19102-1101
Phone
(215) 762-8220
Fax
(215) 762-1470
NPI assigned
Jul 5, 2013
Last updated
Jul 28, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD2017-0292 NM Primary

Addresses

Primary practice location

245 N 15TH St # Ms 495
Philadelphia, PA 19102-1101

Mailing address

2559 Medical Dr
Ste D
Alamogordo, NM 88310-8704
Phone (575) 434-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2017-0292NMMDObstetrics & Gynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1578904504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2559 MEDICAL DR",
            "address_2": "STE D",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108704",
            "telephone_number": "575-434-2229",
            "fax_number": "575-439-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N 15TH ST # MS 495",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021101",
            "telephone_number": "215-762-8220",
            "fax_number": "215-762-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHILLON",
        "first_name": "GURDIAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2017-0292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.