Provider Demographics
NPI:1417914086
Name:SHINGALA, ARUN JAMNADAS (MD)
Entity Type:Individual
Prefix:
First Name:ARUN
Middle Name:JAMNADAS
Last Name:SHINGALA
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 1:141 SALEM AVE
Mailing Address - Street 2:RM 301
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-2574
Mailing Address - Country:US
Mailing Address - Phone:570-282-6928
Mailing Address - Fax:
Practice Address - Street 1:141 SALEM AVE
Practice Address - Street 2:ROOM 301
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2574
Practice Address - Country:US
Practice Address - Phone:570-282-6928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035571L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006696890001Medicaid
PA151554Medicare ID - Type Unspecified
PA0006696890001Medicaid