Provider Demographics
NPI:1154364149
Name:SINGH, AMANDEEP (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDEEP
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10298B BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3670
Mailing Address - Country:US
Mailing Address - Phone:410-465-1091
Mailing Address - Fax:410-465-8129
Practice Address - Street 1:10298B BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3670
Practice Address - Country:US
Practice Address - Phone:410-465-1091
Practice Address - Fax:410-465-8129
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063322207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00313883OtherR/R MEDICARE PROVIDER #
MD572028OtherPTAN
MDCN6601OtherR/R MEDICARE GROUP #
MD409330500Medicaid
MDCA8374OtherR/R MEDICARE GROUP #
MDS589N026Medicare PIN