Provider Demographics
NPI:1891773156
Name:SINGH, JOGINDER (MD, RPT)
Entity Type:Individual
Prefix:MR
First Name:JOGINDER
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 779
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48764-0779
Mailing Address - Country:US
Mailing Address - Phone:989-790-3650
Mailing Address - Fax:989-790-8630
Practice Address - Street 1:5810 GRATIOT RD STE B
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6063
Practice Address - Country:US
Practice Address - Phone:989-790-3650
Practice Address - Fax:989-790-8630
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2021-07-21
Deactivation Date:2018-05-28
Deactivation Code:
Reactivation Date:2018-06-05
Provider Licenses
StateLicense IDTaxonomies
MI5501008587225100000X
MI4301115197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4419737Medicaid
MI0N49370Medicare ID - Type Unspecified