Provider Demographics
NPI:1003640210
Name:SINGH, SHUBHDEEP (MBBS)
Entity type:Individual
Prefix:
First Name:SHUBHDEEP
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 W HURON ST
Mailing Address - Street 2:PONTIAC GENERAL HOSPITAL
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341
Mailing Address - Country:US
Mailing Address - Phone:248-857-7452
Mailing Address - Fax:
Practice Address - Street 1:461 W HURON ST
Practice Address - Street 2:PONTIAC GENERAL HOSPITAL
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-857-7452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351053727390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program