Provider Demographics
NPI:1073650222
Name:SINGH, MANMOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MANMOHAN
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1196
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-1196
Mailing Address - Country:US
Mailing Address - Phone:919-934-2616
Mailing Address - Fax:919-934-5424
Practice Address - Street 1:713 NORTH ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4019
Practice Address - Country:US
Practice Address - Phone:919-934-2616
Practice Address - Fax:919-934-5424
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17900208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC76547OtherBCBS ID NUMBER
NC8976547Medicaid
NC76547OtherBCBS ID NUMBER
NC8976547Medicaid