1659371086 NPI number — CHANDRABHAN SINGH M.D.

Table of content: CHANDRABHAN SINGH M.D. (NPI 1659371086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659371086 NPI number — CHANDRABHAN SINGH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINGH
Provider First Name:
CHANDRABHAN
Provider Middle Name:
Provider Name Prefix Text:
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:
1659371086
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/21/2006
NPI Reactivation Date:
03/27/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1125 W JEFFERSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46131-2140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-738-7878
Provider Business Mailing Address Fax Number:
317-738-7872

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1125 W JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46131-2140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-738-7878
Provider Business Practice Location Address Fax Number:
317-738-7872
Provider Enumeration Date:
07/28/2005

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: 207ZP0105X , with the licence number:  0102555 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100354140A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000083610 . This is a "ANTHEM PROVIDER NUMBER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 351383162 . This is a "TAX ID" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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