Provider Demographics
NPI:1780660613
Name:SINGH, MITHILESH K (MD)
Entity Type:Individual
Prefix:
First Name:MITHILESH
Middle Name:K
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 MILLTOWN RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4084
Mailing Address - Country:US
Mailing Address - Phone:302-993-2330
Mailing Address - Fax:302-993-2344
Practice Address - Street 1:3105 LIMESTONE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2147
Practice Address - Country:US
Practice Address - Phone:302-995-2037
Practice Address - Fax:302-633-9311
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-00060682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001089901Medicaid
DE00A573G66Medicare PIN
G11911Medicare UPIN
DE007196P97Medicare PIN
DE003552M26Medicare PIN
DE0001089901Medicaid
DE007195B93Medicare PIN
DE003791D14Medicare PIN
DE007194O31Medicare PIN