Provider Demographics
NPI:1750576328
Name:PAUL, KAMALJIT SINGH (MD)
Entity type:Individual
Prefix:
First Name:KAMALJIT
Middle Name:SINGH
Last Name:PAUL
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 1:2700W 9TH AVE 207
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-7864
Mailing Address - Country:US
Mailing Address - Phone:920-223-0545
Mailing Address - Fax:920-223-0551
Practice Address - Street 1:2700 W 9TH AVE
Practice Address - Street 2:STE 120
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7247
Practice Address - Country:US
Practice Address - Phone:920-223-0545
Practice Address - Fax:920-223-0551
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27755174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI27755OtherMEDICAL LICENSE NUMBER
WI31451400Medicaid
WIB55630Medicare UPIN