Provider Demographics
NPI:1174523823
Name:SIDHU, HARJIT SINGH (MD)
Entity type:Individual
Prefix:
First Name:HARJIT
Middle Name:SINGH
Last Name:SIDHU
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 1:772 BISHOP WALSH RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1802
Mailing Address - Country:US
Mailing Address - Phone:240-362-7494
Mailing Address - Fax:240-362-7514
Practice Address - Street 1:772 BISHOP WALSH RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1802
Practice Address - Country:US
Practice Address - Phone:240-362-7494
Practice Address - Fax:240-362-7514
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD337201400Medicaid
MD8104HSOtherCAREFIRST BCBS
MD3372014P0001Medicaid
MDD74713Medicare UPIN