Provider Demographics
NPI:1063563120
Name:WALHA, SUKHWANT KAUR (MD)
Entity type:Individual
Prefix:MRS
First Name:SUKHWANT
Middle Name:KAUR
Last Name:WALHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5418
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-5418
Mailing Address - Country:US
Mailing Address - Phone:336-626-2688
Mailing Address - Fax:336-626-4100
Practice Address - Street 1:138 DUBLIN SQUARE RD STE A
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-8601
Practice Address - Country:US
Practice Address - Phone:336-626-2688
Practice Address - Fax:336-626-4100
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC25839208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8985252Medicaid
NC8985252Medicaid
NC211234BMedicare PIN
NCC86950Medicare UPIN