Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD417680 | PA |
NPI | 1154447175 |
---|---|
Provider Name | Robert Singh |
First Address | Royersford, PA 19468-1234 |
Second Address | Philadelphia, PA 19103-3527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 23/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101095280000 | (05) | PA |
I10977 | (02) | PA |
P00899964 | (02) | PA |