Provider Demographics
NPI:1669561775
Name:SINGER, EDWARD SAMUEL (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:SAMUEL
Last Name:SINGER
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 1:1650 OAKWOOD DRIVE
Mailing Address - Street 2:E216
Mailing Address - City:PENN VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19072
Mailing Address - Country:US
Mailing Address - Phone:215-850-6063
Mailing Address - Fax:610-527-4716
Practice Address - Street 1:1650 OAKWOOD DRIVE
Practice Address - Street 2:E216
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072
Practice Address - Country:US
Practice Address - Phone:610-527-4716
Practice Address - Fax:610-527-4716
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011076E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006412490005Medicaid
PA0006412490005Medicaid
019151Medicare ID - Type Unspecified