Provider Demographics
NPI:1912955022
Name:SINGH, SUSHIL K (MD)
Entity Type:Individual
Prefix:
First Name:SUSHIL
Middle Name:K
Last Name:SINGH
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 1:45 RESNIK RD. SUITE 202
Mailing Address - Street 2:MAYFLOWER MEDICAL ASSOCIATES
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-746-0754
Mailing Address - Fax:508-747-7867
Practice Address - Street 1:45 RESNIK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4844
Practice Address - Country:US
Practice Address - Phone:508-746-0754
Practice Address - Fax:508-747-7867
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155264207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2081342Medicaid
MAA37536Medicare ID - Type Unspecified
MAI14869Medicare UPIN