Provider Demographics
NPI:1720583602
Name:UTAMSINGH, POOJA DUSHYANT (MD)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:DUSHYANT
Last Name:UTAMSINGH
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 1:22008 ALTONA DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4770
Mailing Address - Country:US
Mailing Address - Phone:561-479-6173
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST FL 4
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-1005
Practice Address - Country:US
Practice Address - Phone:859-218-2581
Practice Address - Fax:859-257-1632
Is Sole Proprietor?:No
Enumeration Date:2018-03-24
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY56911208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program