Provider Demographics
NPI:1598784092
Name:SINGH, DALJEET (MD)
Entity Type:Individual
Prefix:
First Name:DALJEET
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 1:148 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2547
Mailing Address - Country:US
Mailing Address - Phone:937-323-5001
Mailing Address - Fax:937-323-5413
Practice Address - Street 1:148 W NORTH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2547
Practice Address - Country:US
Practice Address - Phone:937-323-5001
Practice Address - Fax:937-323-5413
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044951S174400000X
OH35-044951207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201319280Medicaid
OH0432562Medicaid
OH9342981OtherPTAN
OH9342981OtherPTAN
OH0481973Medicare PIN