Provider Demographics
NPI:1023597143
Name:SINGH, RAJIVA RANJAN (MD)
Entity type:Individual
Prefix:
First Name:RAJIVA
Middle Name:RANJAN
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 1:3737 SOUTHERN BLVD.
Mailing Address - Street 2:SUITE 4200
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-1262
Mailing Address - Country:US
Mailing Address - Phone:937-294-1489
Mailing Address - Fax:937-297-6468
Practice Address - Street 1:3737 SOUTHERN BLVD.
Practice Address - Street 2:SUITE 4200
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1262
Practice Address - Country:US
Practice Address - Phone:937-294-1489
Practice Address - Fax:937-297-6468
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.133757208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology