Provider Demographics
NPI:1013928332
Name:SINGH, VIDYANAND BUDHRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:VIDYANAND
Middle Name:BUDHRAM
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:VIDYANAND
Other - Middle Name:NANDRASHWAR
Other - Last Name:BUDHRAM SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29115 RACHID LANE
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047
Mailing Address - Country:US
Mailing Address - Phone:586-598-4782
Mailing Address - Fax:
Practice Address - Street 1:51086 FAIRCHILD RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-1998
Practice Address - Country:US
Practice Address - Phone:586-949-3064
Practice Address - Fax:586-949-4367
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4991924Medicaid
MI4994720Medicaid
MI4991924Medicaid
MIN40170099Medicare PIN