Provider Demographics
NPI:1306875588
Name:SINGAL, POOJA (MD)
Entity type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:SINGAL
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 1:100 HOSPITAL LN STE 205
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1993
Mailing Address - Country:US
Mailing Address - Phone:317-745-7445
Mailing Address - Fax:317-745-7449
Practice Address - Street 1:100 HOSPITAL LN STE 205
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1993
Practice Address - Country:US
Practice Address - Phone:317-745-7445
Practice Address - Fax:317-745-7449
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061181A207R00000X
IN01061181207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200825600Medicaid
INP01059157Medicare PIN
INM400022788Medicare PIN
IN715530AQQMedicare PIN
INI59772Medicare UPIN