Provider Demographics
NPI:1982480646
Name:DEWAN, SANNIDHI CHIRAG (MD)
Entity type:Individual
Prefix:
First Name:SANNIDHI
Middle Name:CHIRAG
Last Name:DEWAN
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 1:132 SOUTH 10TH STREET
Mailing Address - Street 2:SUITE 1099J MAIN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5244
Mailing Address - Country:US
Mailing Address - Phone:215-955-6028
Mailing Address - Fax:215-955-1102
Practice Address - Street 1:132 SOUTH 10TH STREET
Practice Address - Street 2:SUITE 1099J MAIN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5244
Practice Address - Country:US
Practice Address - Phone:215-955-6028
Practice Address - Fax:215-955-1102
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program