Provider Demographics
NPI:1194741264
Name:SINGH, JASPAL (MD)
Entity type:Individual
Prefix:
First Name:JASPAL
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15130 LEVAN RD # 30
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5027
Mailing Address - Country:US
Mailing Address - Phone:734-779-2101
Mailing Address - Fax:734-779-2121
Practice Address - Street 1:15130 LEVAN RD STE 30
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5027
Practice Address - Country:US
Practice Address - Phone:734-779-2101
Practice Address - Fax:734-779-2121
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS406441207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M80530003Medicare PIN
MIE16192Medicare UPIN