Provider Demographics
NPI:1427240662
Name:BIRJITENDER SINGH
Entity type:Organization
Organization Name:BIRJITENDER SINGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIRJITENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-791-2455
Mailing Address - Street 1:3061 CHRISTY WAY
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2267
Mailing Address - Country:US
Mailing Address - Phone:989-791-2455
Mailing Address - Fax:
Practice Address - Street 1:140 CAMELOT DR
Practice Address - Street 2:I12
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6459
Practice Address - Country:US
Practice Address - Phone:989-992-4809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5194972Medicaid
MI0P46600Medicare PIN
MII60516Medicare UPIN