Basic Information
Provider Information
NPI: 1316103922
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: PRANAV
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 621 S. ILLINOIS AVE
Address2: SUITE 103
City: MASON CITY
State: IA
PostalCode: 504015489
CountryCode: US
TelephoneNumber: 6414283041
FaxNumber: 6414283059
Practice Location
Address1: 1000 4TH ST SW
Address2: MERCY MEDICAL CENTER-NORTH IOWA
City: MASON CITY
State: IA
PostalCode: 504012800
CountryCode: US
TelephoneNumber: 6414227000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/03/2008
LastUpdateDate: 04/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200X40201IAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001X40201IAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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