Provider Demographics
NPI:1962414581
Name:SIDHU, NAVREET K (MD)
Entity type:Individual
Prefix:DR
First Name:NAVREET
Middle Name:K
Last Name:SIDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3575 PIEDMONT RD NE STE 1500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1623
Mailing Address - Country:US
Mailing Address - Phone:404-487-0363
Mailing Address - Fax:404-474-2012
Practice Address - Street 1:3575 PIEDMONT RD NE STE 1500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1623
Practice Address - Country:US
Practice Address - Phone:404-487-0363
Practice Address - Fax:404-474-2012
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY231471-12084N0402X
GA751422084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02724298Medicaid
NY02724298Medicaid
NY02724298Medicaid