Provider Demographics
NPI:1801812847
Name:INDERJIT SINGH MD PC
Entity type:Organization
Organization Name:INDERJIT SINGH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:INDERJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-694-0334
Mailing Address - Street 1:2296 OPITZ BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3346
Mailing Address - Country:US
Mailing Address - Phone:703-680-2111
Mailing Address - Fax:703-878-3939
Practice Address - Street 1:2296 OPITZ BLVD STE 350
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3346
Practice Address - Country:US
Practice Address - Phone:703-680-2111
Practice Address - Fax:703-878-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048096208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007544189Medicaid