Basic Information
| Provider Information | |||||||||
| NPI: | 1003389081 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREWAL | ||||||||
| FirstName: | HARPREET | ||||||||
| MiddleName: | KAUR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41517 SANCTUARY LN | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481884005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199669338 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25639 FORD RD | ||||||||
| Address2: | |||||||||
| City: | DEARBORN HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481274817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3132773293 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2019 | ||||||||
| LastUpdateDate: | 10/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN.CNP.023503 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 470-4349870 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.