Provider Demographics
NPI:1962616920
Name:MANN, GURBIR SINGH (DPM)
Entity type:Individual
Prefix:
First Name:GURBIR
Middle Name:SINGH
Last Name:MANN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25070 WOODRIDGE DR APT 105
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2285
Mailing Address - Country:US
Mailing Address - Phone:773-330-3429
Mailing Address - Fax:
Practice Address - Street 1:25070 WOODRIDGE DR APT 105
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2285
Practice Address - Country:US
Practice Address - Phone:773-330-3429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002234213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery