Provider Demographics
NPI:1619210143
Name:SINGH, SHRUTI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHRUTI
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1596
Mailing Address - Country:US
Mailing Address - Phone:219-924-8178
Mailing Address - Fax:219-924-8179
Practice Address - Street 1:1001 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1596
Practice Address - Country:US
Practice Address - Phone:219-924-8178
Practice Address - Fax:219-924-8179
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.063191207R00000X
IN01082844A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine