Provider Demographics
NPI:1538115118
Name:SINGAL, KRISHAN (MD)
Entity Type:Individual
Prefix:
First Name:KRISHAN
Middle Name:
Last Name:SINGAL
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 1:415 CRAIN HWY S
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3644
Mailing Address - Country:US
Mailing Address - Phone:410-766-5055
Mailing Address - Fax:410-768-7131
Practice Address - Street 1:415 CRAIN HWY S
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3644
Practice Address - Country:US
Practice Address - Phone:410-766-5055
Practice Address - Fax:410-768-7131
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036900207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD234021600Medicaid
MDC47631Medicare UPIN
MD234021600Medicaid