Provider Demographics
NPI:1285609818
Name:SINGHEL, KENNETH JOHN (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:JOHN
Last Name:SINGHEL
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 S KINGS DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2134
Practice Address - Country:US
Practice Address - Phone:704-446-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01462207R00000X, 207R00000X
NY193565-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA110209250OtherRR MEDICARE PIN
PAGU039812OtherPA MEDICARE GROUP
NC5917675Medicaid
PACC9269OtherRR MEDICARE GROUP
NC1285609818Medicaid
PA0014685220001Medicaid
SCNC1347Medicaid
NY01479390Medicaid
F82322Medicare UPIN
NC2077458Medicare PIN
PA049701N8QMedicare PIN
SCNC1347Medicaid