Provider Demographics
NPI:1144847765
Name:DHALIWAL, GUNVEER KAUR (MD)
Entity type:Individual
Prefix:
First Name:GUNVEER
Middle Name:KAUR
Last Name:DHALIWAL
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:FAMILY MEDICINE RESIDENCY-GUTHRIE/ROBERT PACKER HOSPITA
Mailing Address - Street 2:ONE GUTHRIE SQUARE
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840
Mailing Address - Country:US
Mailing Address - Phone:570-887-3381
Mailing Address - Fax:
Practice Address - Street 1:GUTHRIE/ROBERT PACKER HOSPITAL
Practice Address - Street 2:ONE GUTHRIE SQUARE
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840
Practice Address - Country:US
Practice Address - Phone:570-887-3381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2022-02-08
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-02-03
Provider Licenses
StateLicense IDTaxonomies
PAMT220137390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program