Provider Demographics
NPI:1841062395
Name:SINGH, ISHPREET (PA-C)
Entity type:Individual
Prefix:
First Name:ISHPREET
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 837
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45012-0837
Mailing Address - Country:US
Mailing Address - Phone:513-454-1111
Mailing Address - Fax:
Practice Address - Street 1:1036 S VERITY PKWY
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5513
Practice Address - Country:US
Practice Address - Phone:513-454-1111
Practice Address - Fax:513-737-1592
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008336RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical