Basic Information
| Provider Information | |||||||||
| NPI: | 1306875588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGAL | ||||||||
| FirstName: | POOJA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 HOSPITAL LN STE 205 | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177457445 | ||||||||
| FaxNumber: | 3177457449 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HOSPITAL LN STE 205 | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177457445 | ||||||||
| FaxNumber: | 3177457449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2006 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01061181A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | 01061181 | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 200825600 | 05 | IN | MEDICAID |