Provider Demographics
NPI:1801127568
Name:SINGH, GAGANDIP B (MD)
Entity type:Individual
Prefix:
First Name:GAGANDIP
Middle Name:B
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13634 N. 93RD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381
Mailing Address - Country:US
Mailing Address - Phone:623-933-0301
Mailing Address - Fax:623-933-0224
Practice Address - Street 1:13634 N 93RD AVE STE 100
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4915
Practice Address - Country:US
Practice Address - Phone:239-330-3016
Practice Address - Fax:602-933-0224
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ42686207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ558494Medicaid