Provider Demographics
NPI:1326357849
Name:SINGLETON, EMANUEL BRYANT III (DR, CNP)
Entity Type:Individual
Prefix:MR
First Name:EMANUEL
Middle Name:BRYANT
Last Name:SINGLETON
Suffix:III
Gender:M
Credentials:DR, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6811 MAYFIELD RD APT 1691
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2223
Mailing Address - Country:US
Mailing Address - Phone:440-221-0264
Mailing Address - Fax:
Practice Address - Street 1:10553 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-1973
Practice Address - Country:US
Practice Address - Phone:216-682-7702
Practice Address - Fax:216-920-6273
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020396363LA2100X
OHCNP020396207RA0401X, 363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1326357849Medicaid