Provider Demographics
NPI:1104269307
Name:SINGER, TISHA (MD)
Entity type:Individual
Prefix:
First Name:TISHA
Middle Name:
Last Name:SINGER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:TISHA
Other - Middle Name:
Other - Last Name:ROYSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:227 N LINDBERGH BLVD
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7809
Mailing Address - Country:US
Mailing Address - Phone:636-751-4418
Mailing Address - Fax:
Practice Address - Street 1:227 N LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7809
Practice Address - Country:US
Practice Address - Phone:636-751-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329433-012085R0202X
MO20200296342085R0202X
RIMD151102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200094591Medicaid