Provider Demographics
NPI:1487034385
Name:SINGH, GURWINDER
Entity Type:Individual
Prefix:
First Name:GURWINDER
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14064 LOTUS LN APT 421
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-6359
Mailing Address - Country:US
Mailing Address - Phone:610-657-4056
Mailing Address - Fax:
Practice Address - Street 1:2300 OPITZ BLVD STE G-209
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3311
Practice Address - Country:US
Practice Address - Phone:703-523-0611
Practice Address - Fax:703-670-2089
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101264195208M00000X, 207R00000X
PAMT208163390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program