Provider Demographics
NPI:1114940400
Name:SINGH, ANILKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:ANILKUMAR
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANILKUMAR
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2745 WEST LAYTON AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221
Mailing Address - Country:US
Mailing Address - Phone:414-281-0502
Mailing Address - Fax:414-281-2878
Practice Address - Street 1:2745 WEST LAYTON AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221
Practice Address - Country:US
Practice Address - Phone:414-281-0502
Practice Address - Fax:414-281-2878
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20697208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30172300Medicaid
000001461Medicare ID - Type Unspecified
WI30172300Medicaid