Provider Demographics
NPI:1679675094
Name:SINGH, PRATAP (MD)
Entity Type:Individual
Prefix:DR
First Name:PRATAP
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 1:2520 Q ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-4928
Mailing Address - Country:US
Mailing Address - Phone:812-278-8000
Mailing Address - Fax:812-278-8110
Practice Address - Street 1:2520 Q ST
Practice Address - Street 2:SUITE B
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4928
Practice Address - Country:US
Practice Address - Phone:812-278-8000
Practice Address - Fax:812-278-8110
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055920A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN223720AOtherPTAN INDIVIDUAL MEDICARE
IN200381820AMedicaid
IN223720OtherPTAN GROUP MEDICARE
H27307Medicare UPIN
IN200381820AMedicaid