Basic Information
Provider Information
NPI: 1982692695
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: NAVDEEP
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 BRADY ST
Address2:  
City: CHESANING
State: MI
PostalCode: 486161086
CountryCode: US
TelephoneNumber: 9898451800
FaxNumber: 9898451820
Practice Location
Address1: 1600 BRADY ST
Address2:  
City: CHESANING
State: MI
PostalCode: 486161086
CountryCode: US
TelephoneNumber: 9898451800
FaxNumber: 9898451820
Other Information
ProviderEnumerationDate: 10/07/2005
LastUpdateDate: 12/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X4301077792MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
080731134201MIBCBS PROVIDER IDOTHER


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