Provider Demographics
NPI:1285640896
Name:SINGER, IGOR (MD)
Entity Type:Individual
Prefix:
First Name:IGOR
Middle Name:
Last Name:SINGER
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 1:3801 SPRINGHURST BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6137
Mailing Address - Country:US
Mailing Address - Phone:502-425-5614
Mailing Address - Fax:502-425-5633
Practice Address - Street 1:3801 SPRINGHURST BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-6137
Practice Address - Country:US
Practice Address - Phone:502-425-5614
Practice Address - Fax:502-425-5633
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25392207RC0000X
IL036109211207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1177433OtherCHA
KY64253925Medicaid
IL7215059OtherBCBS PPO
ILP00132363OtherRAILROAD MEDICARE
000000527843OtherANTHEM BCBS
KY2864651OtherPASSPORT ADVANTAGE
ILIL01M7OtherJOHN DEERE
IL0361092111Medicaid
IL084969OtherHEALTH ALLIANCE
IN200059350Medicaid
4045202OtherAETNA
KY50016393OtherPASSPORT
IL623711OtherHEALTHLINK
KY64253925Medicaid
KY00280072Medicare PIN
KY2864651OtherPASSPORT ADVANTAGE
ILC69094Medicare UPIN
IN253930AMedicare PIN