Provider Demographics
NPI:1124038393
Name:SINGZON, JAIME MERIDA (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:MERIDA
Last Name:SINGZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:MERIDA
Other - Last Name:SINGZON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1159 ELM RD
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN
Mailing Address - State:PA
Mailing Address - Zip Code:17872-7629
Mailing Address - Country:US
Mailing Address - Phone:707-548-4840
Mailing Address - Fax:
Practice Address - Street 1:1159 ELM RD
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-7629
Practice Address - Country:US
Practice Address - Phone:707-548-4840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41529207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA88568Medicare UPIN