Basic Information
Provider Information
NPI: 1699766030
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGLETON
FirstName: SHELIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 555 SAINT CLAIR RIVER DR
Address2:  
City: ALGONAC
State: MI
PostalCode: 480011802
CountryCode: US
TelephoneNumber: 8107944982
FaxNumber: 8107944407
Practice Location
Address1: 555 SAINT CLAIR RIVER DR
Address2:  
City: ALGONAC
State: MI
PostalCode: 480011802
CountryCode: US
TelephoneNumber: 8107944982
FaxNumber: 8107944407
Other Information
ProviderEnumerationDate: 11/03/2005
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X4301067070MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
457836805MI MEDICAID


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