Provider Demographics
NPI:1184830168
Name:MANMOHAN SINGH M.D. P.C.
Entity type:Organization
Organization Name:MANMOHAN SINGH M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANMOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-4800
Mailing Address - Street 1:PO BOX 3085
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-0085
Mailing Address - Country:US
Mailing Address - Phone:219-836-4800
Mailing Address - Fax:
Practice Address - Street 1:110 RIDGE RD
Practice Address - Street 2:SUITE 11
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1520
Practice Address - Country:US
Practice Address - Phone:219-836-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052302A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200268760Medicaid
IN200268760Medicaid
IND13393Medicare UPIN