Provider Demographics
NPI:1740817584
Name:SINGH-WARDEN, ELIZABETH ANURADHA (DO, MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANURADHA
Last Name:SINGH-WARDEN
Suffix:
Gender:F
Credentials:DO, MS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 CLARK RD STE 3
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1698
Mailing Address - Country:US
Mailing Address - Phone:978-851-4141
Mailing Address - Fax:
Practice Address - Street 1:600 CLARK RD STE 3
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1698
Practice Address - Country:US
Practice Address - Phone:978-851-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA1016299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program