Provider Demographics
NPI:1881651743
Name:SINGH, GAGAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:GAGAN
Middle Name:J
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 1:18412 CROWNSGATE CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4416
Mailing Address - Country:US
Mailing Address - Phone:304-725-2121
Mailing Address - Fax:
Practice Address - Street 1:201 E 5TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-1613
Practice Address - Country:US
Practice Address - Phone:304-725-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21033207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02476G01Medicare PIN
H39643Medicare UPIN
WV4099782Medicare PIN
MDG02476Medicare PIN
WV9340831Medicare PIN