Provider Demographics
NPI:1629052691
Name:SINGH, PARDUMAN (MD)
Entity Type:Individual
Prefix:
First Name:PARDUMAN
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 1:4610 TRADEMARK TRL
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7481
Mailing Address - Country:US
Mailing Address - Phone:330-402-3894
Mailing Address - Fax:330-793-3313
Practice Address - Street 1:4610 TRADEMARK TRL
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7481
Practice Address - Country:US
Practice Address - Phone:330-402-3894
Practice Address - Fax:330-793-3313
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35047526S2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0511066Medicaid
OH000000291637OtherOH MEDICAID UNISON
OH310917085221OtherOH MEDICAID CARESOURCE
OH0511066OtherOH MEDCAID MOLINA
WV3810016754Medicaid
OH0511066OtherOH MEDCAID MOLINA
OH310917085221OtherOH MEDICAID CARESOURCE