Provider Demographics
NPI:1164063210
Name:SINGAL, SURINDER K
Entity Type:Individual
Prefix:
First Name:SURINDER
Middle Name:K
Last Name:SINGAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 DEALE CHURCHTON RD
Mailing Address - Street 2:
Mailing Address - City:DEALE
Mailing Address - State:MD
Mailing Address - Zip Code:20751-2203
Mailing Address - Country:US
Mailing Address - Phone:410-867-2455
Mailing Address - Fax:410-867-2466
Practice Address - Street 1:5809 DEALE CHURCHTON RD
Practice Address - Street 2:
Practice Address - City:DEALE
Practice Address - State:MD
Practice Address - Zip Code:20751-2203
Practice Address - Country:US
Practice Address - Phone:410-867-2455
Practice Address - Fax:410-867-2466
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist