Provider Demographics
NPI:1851068829
Name:SINGH, GURJEET
Entity Type:Individual
Prefix:
First Name:GURJEET
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 INDUSTRIAL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1742
Mailing Address - Country:US
Mailing Address - Phone:734-944-8300
Mailing Address - Fax:
Practice Address - Street 1:1235 INDUSTRIAL DR STE 4
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1742
Practice Address - Country:US
Practice Address - Phone:734-944-8300
Practice Address - Fax:248-780-3805
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2023-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704338756163WG0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice