Provider Demographics
NPI:1073778585
Name:SINGH, GAGANDEEP (MD)
Entity Type:Individual
Prefix:
First Name:GAGANDEEP
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 1:3108 HONEYWOOD LN APT K
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8830
Mailing Address - Country:US
Mailing Address - Phone:540-765-2373
Mailing Address - Fax:
Practice Address - Street 1:700 UNIVERSITY CITY BLVD
Practice Address - Street 2:NEW RIVER COMMUNITY SERVICES
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-2706
Practice Address - Country:US
Practice Address - Phone:540-961-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012496252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry