Provider Demographics
NPI:1417977083
Name:SINGH, DEEPJOT (MD)
Entity type:Individual
Prefix:
First Name:DEEPJOT
Middle Name:
Last Name:SINGH
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 1:101 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-3413
Mailing Address - Country:US
Mailing Address - Phone:360-678-7624
Mailing Address - Fax:360-678-7653
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3413
Practice Address - Country:US
Practice Address - Phone:360-678-7624
Practice Address - Fax:360-678-7653
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61194654207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00250204OtherRAILROAD MEDICARE
OH2511295Medicaid
OH000000539603OtherANTHEM
OH364019OtherWELLCARE
OH000000229162OtherUNISON
WA2196220Medicaid
OH741835OtherBUCKEYE
OH7591698OtherAETNA
OHP00449232OtherRAILROAD MEDICARE
OH7591698OtherAETNA
OHP00449232OtherRAILROAD MEDICARE