Provider Demographics
NPI:1669166716
Name:ADVANCED FIRST STATE MEDICAL PRACTICE PLLC
Entity type:Organization
Organization Name:ADVANCED FIRST STATE MEDICAL PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BIRJITENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-790-3450
Mailing Address - Street 1:3406 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3374
Mailing Address - Country:US
Mailing Address - Phone:989-790-3450
Mailing Address - Fax:989-401-6201
Practice Address - Street 1:3406 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3374
Practice Address - Country:US
Practice Address - Phone:989-790-3450
Practice Address - Fax:989-401-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty