Provider Demographics
NPI:1962595850
Name:SINGHAL, ABHAY (MD)
Entity type:Individual
Prefix:
First Name:ABHAY
Middle Name:
Last Name:SINGHAL
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 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-274-1201
Mailing Address - Fax:317-278-9905
Practice Address - Street 1:2401 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3428
Practice Address - Country:US
Practice Address - Phone:765-751-2650
Practice Address - Fax:765-751-2629
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051710A208000000X, 2080N0001X
IN010517102080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000639574OtherANTHEM PROVIDER NUMBER
IN815500DD6OtherMEDICARE PTAN
INM12240469OtherMEDICARE PTAN
IL036104821Medicaid
OH3073221Medicaid
IN200277130Medicaid