Provider Demographics
NPI:1215927579
Name:SINGH, AJAY KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:KUMAR
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13280 EVENING CREEK DR S STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4109
Mailing Address - Country:US
Mailing Address - Phone:585-463-8008
Mailing Address - Fax:858-546-3900
Practice Address - Street 1:2 AVERY ST
Practice Address - Street 2:#32H
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1002
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA123239002085R0202X
ARE-165042085R0202X
AZ634842085R0202X
PAMD4581652085R0202X
MA2167142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H84778Medicare UPIN
MA216714OtherTUFTS HEALTH PLAN
MAJ25926OtherBCBS MA
MAA35301Medicare ID - Type Unspecified
MA2012545Medicaid