Charnpreet Singh Dhaliwal, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016113 Issued in MI

Practice address

19785 W 12 Mile Road
Suite 675
Southfield, MI 48076-2584

Phone

(248) 213-8294

Fax

(248) 443-0165

NPI assigned

Nov 20, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1760726384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7633 E JEFFERSON AVE STE 200",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143732",
            "telephone_number": "313-651-7170",
            "fax_number": "313-824-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19785 W 12 MILE ROAD",
            "address_2": "SUITE 675",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762584",
            "telephone_number": "248-213-8294",
            "fax_number": "248-443-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "CHARNPREET",
        "middle_name": "SINGH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN -IHG",
            "identifier": "0P12330",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT STATE LICENSE",
            "identifier": "5501016113",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI #",
            "identifier": "1760726384",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 BCBS PIN- IHG",
            "identifier": "OH28276",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "12476799",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 BCBS PIN",
            "identifier": "OH70561",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 NPI #- IHG PT GROUP",
            "identifier": "1144562083",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHG TAX ID#",
            "identifier": "010822105",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.