Provider Demographics
NPI:1083609093
Name:SINGH, SANJEEV K (DPM)
Entity Type:Individual
Prefix:DR
First Name:SANJEEV
Middle Name:K
Last Name:SINGH
Suffix:
Gender:M
Credentials:DPM
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 1166
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-1166
Mailing Address - Country:US
Mailing Address - Phone:334-566-9400
Mailing Address - Fax:334-566-9408
Practice Address - Street 1:1350 HWY 231 SOUTH SUITE A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081
Practice Address - Country:US
Practice Address - Phone:334-566-9400
Practice Address - Fax:334-566-9408
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL133213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL74167OtherBCBS
ALU34768Medicare UPIN
AL74167OtherBCBS