1497877377 NPI number — DR. RAVIKUMAR SINGH MD

Table of content: DR. RAVIKUMAR SINGH MD (NPI 1497877377)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497877377 NPI number — DR. RAVIKUMAR SINGH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINGH
Provider First Name:
RAVIKUMAR
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497877377
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
245 ST HELENS AVE # 108
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98402-2594
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-218-3035
Provider Business Mailing Address Fax Number:
855-292-0966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GRAYS HARBOR COMMUNITY HOSPITAL
Provider Second Line Business Practice Location Address:
915 ANDERSON DRIVE
Provider Business Practice Location Address City Name:
ABERDEEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-532-8330
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  E-5283 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: MD43771 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: E5283 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: MD61030731 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1506376 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".