Provider Demographics
NPI:1740224500
Name:SINGH, JAGDEV I (MD)
Entity Type:Individual
Prefix:
First Name:JAGDEV
Middle Name:I
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2669 SCENIC DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-8700
Mailing Address - Country:US
Mailing Address - Phone:575-437-1900
Mailing Address - Fax:575-437-3322
Practice Address - Street 1:1212 9TH ST
Practice Address - Street 2:STE BC
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5842
Practice Address - Country:US
Practice Address - Phone:575-434-2578
Practice Address - Fax:575-434-8773
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-03-10
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Provider Licenses
StateLicense IDTaxonomies
NM72-231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NME02928Medicare UPIN
NM2121149Medicare ID - Type Unspecified