Provider Demographics
NPI:1467483891
Name:SINGH, SHAMSHER (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAMSHER
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 1:1701 SE HILLMOOR DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7552
Mailing Address - Country:US
Mailing Address - Phone:772-335-8200
Mailing Address - Fax:772-335-2042
Practice Address - Street 1:1701 SE HILLMOOR DR
Practice Address - Street 2:SUITE 3
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7552
Practice Address - Country:US
Practice Address - Phone:772-335-8200
Practice Address - Fax:772-335-2042
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31654207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56763Medicare UPIN
FL56104Medicare ID - Type Unspecified