Provider Demographics
NPI:1811966377
Name:SINGH, SANJEEV (PA)
Entity type:Individual
Prefix:
First Name:SANJEEV
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:PA
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Other - Last Name:
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Mailing Address - Street 1:2 CARDINAL PARK DR SE
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4448
Mailing Address - Country:US
Mailing Address - Phone:703-777-8840
Mailing Address - Fax:703-777-8150
Practice Address - Street 1:2 CARDINAL PARK DR SE
Practice Address - Street 2:SUITE 103A
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4448
Practice Address - Country:US
Practice Address - Phone:703-777-8840
Practice Address - Fax:703-777-8150
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110001054363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant