Provider Demographics
NPI:1487724886
Name:MALHOTRA, GURDEEP KAUR (MD)
Entity type:Individual
Prefix:DR
First Name:GURDEEP
Middle Name:KAUR
Last Name:MALHOTRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3283 CHATEAU DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2471
Mailing Address - Country:US
Mailing Address - Phone:740-353-5984
Mailing Address - Fax:740-354-1565
Practice Address - Street 1:3283 CHATEAU DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2471
Practice Address - Country:US
Practice Address - Phone:740-353-5984
Practice Address - Fax:740-354-1565
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-048582174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist