Provider Demographics
NPI:1427024421
Name:SINGER, JERRY R (MD)
Entity Type:Individual
Prefix:
First Name:JERRY
Middle Name:R
Last Name:SINGER
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 1:1070 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4138
Mailing Address - Country:US
Mailing Address - Phone:276-781-2225
Mailing Address - Fax:276-783-8843
Practice Address - Street 1:1070 TERRACE DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4138
Practice Address - Country:US
Practice Address - Phone:276-781-2225
Practice Address - Fax:276-783-8843
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037189207R00000X
PAMD035702E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1427024421Medicaid
VAP01246019OtherRAILROAD MEDICARE
VAP00357824OtherRR MEDICARE
VAP01246019OtherRAILROAD MEDICARE
VAP00357824OtherRR MEDICARE