Provider Demographics
NPI:1760454482
Name:SINGH, ANUP (MD)
Entity Type:Individual
Prefix:
First Name:ANUP
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 1:966B PARK ST # B
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3650
Mailing Address - Country:US
Mailing Address - Phone:781-344-3506
Mailing Address - Fax:781-341-4065
Practice Address - Street 1:966B PARK ST # B
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3650
Practice Address - Country:US
Practice Address - Phone:781-344-3506
Practice Address - Fax:781-341-4065
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59819208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3035361Medicaid
MAB98206Medicare UPIN
MAJ07491Medicare PIN