Provider Demographics
NPI:1386033637
Name:SINGH MEDICAL & WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:SINGH MEDICAL & WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MANPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-382-8899
Mailing Address - Street 1:3645 OAKMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:NORMANDY
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4906
Mailing Address - Country:US
Mailing Address - Phone:314-382-8899
Mailing Address - Fax:
Practice Address - Street 1:3645 OAKMOUNT AVE
Practice Address - Street 2:
Practice Address - City:NORMANDY
Practice Address - State:MO
Practice Address - Zip Code:63121-4906
Practice Address - Country:US
Practice Address - Phone:314-382-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMOB5718207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty