Provider Demographics
NPI:1215423744
Name:VIRK, GURPINDERJIT (MD)
Entity type:Individual
Prefix:
First Name:GURPINDERJIT
Middle Name:
Last Name:VIRK
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 1:102 LLOYD SANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:BRAMPTON
Mailing Address - State:ON
Mailing Address - Zip Code:L6Y 0X2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1266
Practice Address - Country:US
Practice Address - Phone:517-748-5500
Practice Address - Fax:517-780-9286
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301115575390200000X
MI4301505222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program