Provider Demographics
NPI:1821007360
Name:SINGH, BALJEET (MD)
Entity Type:Individual
Prefix:
First Name:BALJEET
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 1:13820 N 51ST AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4885
Mailing Address - Country:US
Mailing Address - Phone:602-938-2300
Mailing Address - Fax:
Practice Address - Street 1:13820 N 51ST AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4885
Practice Address - Country:US
Practice Address - Phone:602-938-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18578207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ288127Medicaid
AZ288127Medicaid
AZA15918Medicare UPIN