Provider Demographics
NPI:1114318037
Name:SINGH, KAMALDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALDEEP
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 1:5410 MARYLAND WAY
Mailing Address - Street 2:#300
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5339
Mailing Address - Country:US
Mailing Address - Phone:161-537-1442
Mailing Address - Fax:
Practice Address - Street 1:123 W 227TH ST
Practice Address - Street 2:#2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-6732
Practice Address - Country:US
Practice Address - Phone:510-789-5067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KYTP923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program