Provider Demographics
NPI:1386741387
Name:SINGH, SANTOSH K (MD)
Entity type:Individual
Prefix:MRS
First Name:SANTOSH
Middle Name:K
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 1:1605 W KEM ROAD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-1735
Mailing Address - Country:US
Mailing Address - Phone:765-668-8800
Mailing Address - Fax:765-668-8814
Practice Address - Street 1:1605 W KEM ROAD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-1735
Practice Address - Country:US
Practice Address - Phone:765-668-8800
Practice Address - Fax:765-668-8814
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035011101YM0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100124060AMedicaid
IN000000088636OtherBLSH
IN197353OtherCIGNA VALUE OPTIONS
IN068355000OtherMAGELLAN
IN100124060AMedicaid
IN068355000OtherMAGELLAN