Provider Demographics
NPI:1023337003
Name:KENTLANDS MEDICAL ASSOCIATES P.C
Entity type:Organization
Organization Name:KENTLANDS MEDICAL ASSOCIATES P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUPINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-632-0333
Mailing Address - Street 1:344 MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5563
Mailing Address - Country:US
Mailing Address - Phone:240-632-0333
Mailing Address - Fax:240-632-0661
Practice Address - Street 1:344 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5563
Practice Address - Country:US
Practice Address - Phone:240-632-0333
Practice Address - Fax:240-632-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-30
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055335261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD095951100Medicaid
MD095951100Medicaid