Provider Demographics
NPI:1235260696
Name:SINGH, INDER PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:INDER
Middle Name:PAUL
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 1:135 WHITNEY VALLEY WALK
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2462
Mailing Address - Country:US
Mailing Address - Phone:770-449-7888
Mailing Address - Fax:770-493-1860
Practice Address - Street 1:2130 LAVISTA EXEC PARK DR
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5421
Practice Address - Country:US
Practice Address - Phone:770-493-1800
Practice Address - Fax:770-493-1860
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040551207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00676574BMedicaid
08BDPDGMedicare ID - Type Unspecified
GA00676574BMedicaid