Provider Demographics
NPI:1154563203
Name:DHILLON, VARINDER S (MD)
Entity type:Individual
Prefix:
First Name:VARINDER
Middle Name:S
Last Name:DHILLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7590 AUBURN ROAD, SUITE 014
Mailing Address - Street 2:ATTN: MED STAFF
Mailing Address - City:CONCORD TWP.
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9176
Mailing Address - Country:US
Mailing Address - Phone:440-354-1899
Mailing Address - Fax:440-354-1845
Practice Address - Street 1:2747 SOM CENTER RD
Practice Address - Street 2:SUITE D
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9164
Practice Address - Country:US
Practice Address - Phone:440-516-0530
Practice Address - Fax:440-516-0492
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-0969572207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3149006Medicaid
OH3149006Medicaid