Provider Demographics
NPI:1558590901
Name:SINGH, NICKLESH N (MD)
Entity Type:Individual
Prefix:DR
First Name:NICKLESH
Middle Name:N
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2480 LLEWELLYN AVE STE 5800
Mailing Address - Street 2:
Mailing Address - City:FORT GEORGE G MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755-5129
Mailing Address - Country:US
Mailing Address - Phone:301-677-8212
Mailing Address - Fax:301-677-8013
Practice Address - Street 1:2480 LLEWELLYN AVE STE 5800
Practice Address - Street 2:
Practice Address - City:FORT GEORGE G MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755-5129
Practice Address - Country:US
Practice Address - Phone:301-677-8212
Practice Address - Fax:301-677-8013
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-34631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine