Basic Information
| Provider Information | |||||||||
| NPI: | 1144239831 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BINDRA | ||||||||
| FirstName: | RAJVINDER | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11101 N SHERMAN RD | ||||||||
| Address2: | |||||||||
| City: | EDGERTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535349002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088843441 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11101 N SHERMAN RD | ||||||||
| Address2: | |||||||||
| City: | EDGERTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535349002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088843441 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 10/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 40010 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1144239831 | 05 | WI | MEDICAID | 1144239831 | 01 | WI | BLUE CROSS BLUE SHIELD | OTHER |