Provider Demographics
NPI:1356317622
Name:SINGH, TEJDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:TEJDEEP
Middle Name:
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 1:4694 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1012
Mailing Address - Country:US
Mailing Address - Phone:330-480-7655
Mailing Address - Fax:330-759-3851
Practice Address - Street 1:4694 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1012
Practice Address - Country:US
Practice Address - Phone:330-480-7655
Practice Address - Fax:330-759-3851
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.051609207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH401252OtherMEDICARE PTAN
OH0599188Medicaid
OHH401252OtherMEDICARE PTAN
OH0599188Medicaid