Provider Demographics
NPI:1619409240
Name:SINGH, JASVINDER AUTAR (MD)
Entity Type:Individual
Prefix:DR
First Name:JASVINDER
Middle Name:AUTAR
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 1:17805 FRUITWOOD LN
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-3572
Mailing Address - Country:US
Mailing Address - Phone:952-220-1724
Mailing Address - Fax:
Practice Address - Street 1:1655 BEAM AVE STE 102
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1475
Practice Address - Country:US
Practice Address - Phone:612-625-2661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-02
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN72624208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine