Provider Demographics
NPI: | 1649229964 |
---|---|
Name: | SINGH, RAJINDER PAL (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | RAJINDER |
Middle Name: | PAL |
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: | 860 OMNI BLVD |
Mailing Address - Street 2: | SUITE 303 |
Mailing Address - City: | NEWPORT NEWS |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23606-4430 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 757-232-8769 |
Mailing Address - Fax: | 757-232-8875 |
Practice Address - Street 1: | 802 LOCKWOOD AVE |
Practice Address - Street 2: | SUITE A |
Practice Address - City: | NEWPORT NEWS |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23602-4479 |
Practice Address - Country: | US |
Practice Address - Phone: | 757-872-9797 |
Practice Address - Fax: | 757-872-9711 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-05-06 |
Last Update Date: | 2024-07-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0101041732 | 2084N0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
VA | 394415 | Other | ANTHEM |
VA | 130019108 | Other | RAILROAD MEDICARE |
VA | 7116497 | Medicaid | |
VA | 130000714 | Medicare PIN | |
VA | 7116497 | Medicaid | |
G30728 | Medicare UPIN |