Provider Demographics
NPI:1619195732
Name:SINGAPURI, MOHAMMED SALMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:SALMAN
Last Name:SINGAPURI
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 1:40 VALLEY STREAM PKWY
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5246 SNAPFINGER PARK DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-4044
Practice Address - Country:US
Practice Address - Phone:678-533-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28301207R00000X
ARE8554207RN0300X
GA060990207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5CC99OtherBCBS
AL51007084OtherBCBS
AL009913548Medicaid
AR206432001Medicaid
AL510I110042Medicare PIN
AL51007084OtherBCBS
AR360288YJPDMedicare PIN