Provider Demographics
NPI:1306291323
Name:RANDHAWA, SANGRAM SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:SANGRAM
Middle Name:SINGH
Last Name:RANDHAWA
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 1:1900 N. HIGLEY ROAD
Mailing Address - Street 2:ATTN: AMANDA GUMP/HOSPITALIST TEAM
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234
Mailing Address - Country:US
Mailing Address - Phone:480-543-2034
Mailing Address - Fax:480-543-2647
Practice Address - Street 1:1800 E. FLORENCE BLVD.
Practice Address - Street 2:ATTN: AMANDA GUMP/HOSPITALIST TEAM
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122
Practice Address - Country:US
Practice Address - Phone:480-543-2034
Practice Address - Fax:480-543-2647
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2019-09-23
Deactivation Date:2016-12-21
Deactivation Code:
Reactivation Date:2017-01-11
Provider Licenses
StateLicense IDTaxonomies
AZ57674207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine