Provider Demographics
NPI:1639185572
Name:SINGER, GREGORY MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MITCHELL
Last Name:SINGER
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 1:1783 CREEK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051-1716
Mailing Address - Country:US
Mailing Address - Phone:610-285-2173
Mailing Address - Fax:
Practice Address - Street 1:1783 CREEK VIEW DR
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-1716
Practice Address - Country:US
Practice Address - Phone:610-285-2173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-064098L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG64210Medicare UPIN
PA002452YUNMMedicare PIN
PA002452YEBKMedicare PIN