Provider Demographics
NPI:1609813260
Name:SINGLA, AJAY KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:AJAY
Middle Name:KUMAR
Last Name:SINGLA
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 1:3355 GLENDALE AVE
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3120 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-5811
Practice Address - Country:US
Practice Address - Phone:419-383-3578
Practice Address - Fax:419-383-2825
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077387208800000X
OH35120277208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4887247Medicare PIN