Basic Information
Provider Information
NPI: 1497941728
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: GURTEJ
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 13059
Address2:  
City: BELFAST
State: ME
PostalCode: 049154021
CountryCode: US
TelephoneNumber: 8124851220
FaxNumber:  
Practice Location
Address1: 901 SAINT MARYS DR
Address2: STE 300
City: EVANSVILLE
State: IN
PostalCode: 477140520
CountryCode: US
TelephoneNumber: 8124732642
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/20/2007
LastUpdateDate: 12/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X01066427AINY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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