1174590681 NPI number — DR. MADHVENDRA SINGH M.D

Table of content: DR. MADHVENDRA SINGH M.D (NPI 1174590681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174590681 NPI number — DR. MADHVENDRA SINGH M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINGH
Provider First Name:
MADHVENDRA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
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:
1174590681
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BLUE HILLS MEDICAL ASSOCIATES
Provider Second Line Business Mailing Address:
340 WOOD ROAD
Provider Business Mailing Address City Name:
BRAINTREE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02184
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-849-1111
Provider Business Mailing Address Fax Number:
781-794-2288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BLUE HILLS MEDICAL ASSOCIATES
Provider Second Line Business Practice Location Address:
340 WOOD ROAD
Provider Business Practice Location Address City Name:
BRAINTREE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-849-1111
Provider Business Practice Location Address Fax Number:
781-794-2288
Provider Enumeration Date:
03/02/2006

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: 207R00000X , with the licence number:  80938 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 69719 . This is a "HARVARD PILGRIM NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0403207 . This is a "UNITED HEALTHCARE #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3168875 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: B10325801 . This is a "CIGNA NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2345691 . This is a "AETNA NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 773330 . This is a "TUFTS NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J17965 . This is a "BLUE SHIELD NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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