Provider Demographics
NPI:1134208473
Name:SINGH, REKHA (MD)
Entity type:Individual
Prefix:MISS
First Name:REKHA
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 LAWRENCEVILLE SUWANEE ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024
Mailing Address - Country:US
Mailing Address - Phone:678-482-5550
Mailing Address - Fax:678-730-0996
Practice Address - Street 1:2880 LAWRENCEVILLE SUWANEE ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024
Practice Address - Country:US
Practice Address - Phone:678-482-5550
Practice Address - Fax:678-730-0996
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA38154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00612235FMedicaid
GA00612235FMedicaid
GA08BDPXXMedicare ID - Type Unspecified