Provider Demographics
NPI:1164409561
Name:WALHA, SANTOKH SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:SANTOKH
Middle Name:SINGH
Last Name:WALHA
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 1:2675 WINKLER AVE FL 2FLOOR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:9371 CYPRESS LAKE DR STE 16
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4945
Practice Address - Country:US
Practice Address - Phone:239-454-0500
Practice Address - Fax:239-454-0663
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72023207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253868700Medicaid
F59607Medicare UPIN