Provider Demographics
NPI:1346461571
Name:HANOVER FAMILY HEALTH & URGENT CARE PC
Entity Type:Organization
Organization Name:HANOVER FAMILY HEALTH & URGENT CARE PC
Other - Org Name:SURENDER SINGH MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SURENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-829-1000
Mailing Address - Street 1:1399 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339
Mailing Address - Country:US
Mailing Address - Phone:781-829-1000
Mailing Address - Fax:781-829-9117
Practice Address - Street 1:1399 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339
Practice Address - Country:US
Practice Address - Phone:781-829-0895
Practice Address - Fax:781-829-9117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA053103OtherTUFT
MAJ08042Medicare ID - Type Unspecified
D87894Medicare UPIN