Provider Demographics
NPI:1730617366
Name:DHALIWAL, BALDEEP (MD)
Entity type:Individual
Prefix:MR
First Name:BALDEEP
Middle Name:
Last Name:DHALIWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CAPNER COURT
Mailing Address - Street 2:
Mailing Address - City:KLEINBURG
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L0J1C0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2018-01-10
Deactivation Date:2018-01-03
Deactivation Code:
Reactivation Date:2018-01-04
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program