Provider Demographics
NPI:1093793663
Name:SINGH, SHALINI (DO)
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 MONCLOVA RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1863
Mailing Address - Country:US
Mailing Address - Phone:419-887-8780
Mailing Address - Fax:419-887-8781
Practice Address - Street 1:5757 MONCLOVA RD
Practice Address - Street 2:SUITE 11
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1863
Practice Address - Country:US
Practice Address - Phone:419-887-8780
Practice Address - Fax:419-887-8781
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000370478OtherANTHEM
OH04509OtherPARAMOUNT
OH2451270Medicaid
OHH98050Medicare UPIN
OH2451270Medicaid