| Doctor Name: | BALJIT S SIDHU |
| NPI Number: | 1073580221 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101031126 |
| Business Practice Address: | 4710 Puddledock Rd Suite 100 Prince George, VA - 238751237 |
| Business Phone Number: | 8047320095 |
| Business Fax Number: | 8047320055 |
| Mailing Address: | 1115 Boulders Pkwy, Suite 200 NORTH CHESTERFIELD |
| State: | VA |
| Postal Code: | 232254067 |
| Phone Number: | 8045605595 |
| Fax Number: | 8045609029 |
| NPI Enumeration Date: | 03/07/2006 |
| NPI Last Update Date: | 12/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 0101031126 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |