Provider Demographics
NPI:1063517415
Name:ALBEMARLE PULMONARY MEDICINE ASSOCIATES
Entity type:Organization
Organization Name:ALBEMARLE PULMONARY MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASVINDER
Authorized Official - Middle Name:PAL
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-338-6167
Mailing Address - Street 1:1507 NORTH ROAD STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909
Mailing Address - Country:US
Mailing Address - Phone:252-338-6167
Mailing Address - Fax:252-334-1755
Practice Address - Street 1:1507 NORTH ROAD STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909
Practice Address - Country:US
Practice Address - Phone:252-338-6167
Practice Address - Fax:252-334-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33893207RC0200X, 207RG0300X, 207RS0012X, 207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
72539OtherMEDCOST
NC891038TMedicaid
NC0173XOtherBCBS OF NC
NC690280QMedicaid
437123OtherALLIANCE PPO
NC890173XMedicaid
290008758OtherMEDICARE RAILROAD
NC690280UMedicaid
NC1038TOtherBCBS OF NC
4854877OtherUNITED HEALTH CARE
2327994OtherPTAN-MEDICARE
559755360OtherCHAMPUS
2164379BOtherMEDICARE
NC641984OtherBCBS OF NC
NC890173XMedicaid