Provider Demographics
NPI:1932276326
Name:SINGH, JASMINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8401 MEDICAL PLAZA DR STE 250
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8700
Practice Address - Country:US
Practice Address - Phone:704-384-1500
Practice Address - Fax:704-384-1525
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097058207R00000X
NC2011-00264207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL364482030OtherTAX ID FOR COMMERCIAL INS
IL036097058Medicaid
IL1622782OtherBCBS PROVIDER NUMBER
ILK03745Medicare ID - Type UnspecifiedCOOK COUNTY PROVIDER NUMB
IL364482030OtherTAX ID FOR COMMERCIAL INS
ILK18552Medicare ID - Type UnspecifiedDUPAGE COUNTY PROVIDR NUM