Provider Demographics
NPI:1225178833
Name:SINGH, MAMTA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAMTA
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 SW 75TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5779
Mailing Address - Country:US
Mailing Address - Phone:352-331-5277
Mailing Address - Fax:352-331-5260
Practice Address - Street 1:100 SW 75TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5779
Practice Address - Country:US
Practice Address - Phone:352-331-5277
Practice Address - Fax:352-331-5260
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME87889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL81605WMedicare Oscar/Certification
FLH98382Medicare UPIN