Provider Demographics
NPI:1255684353
Name:SINGER, SAMANTHA FAY (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:FAY
Last Name:SINGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 BINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9951
Mailing Address - Country:US
Mailing Address - Phone:717-516-2162
Mailing Address - Fax:
Practice Address - Street 1:3940 ARROWHEAD BLVD STE 110
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7637
Practice Address - Country:US
Practice Address - Phone:919-568-7328
Practice Address - Fax:919-568-7389
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000853363AS0400X
PAMA056312363AS0400X
NC0010-08229363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103382813Medicaid