Provider Demographics
NPI:1184073801
Name:SINGH, GAURAV (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:GAURAV
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 N VAN BUREN ST APT 1910
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3862
Mailing Address - Country:US
Mailing Address - Phone:630-448-0402
Mailing Address - Fax:936-213-6342
Practice Address - Street 1:2600 N MAYFAIR RD STE 810
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-771-1122
Practice Address - Fax:414-771-1352
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME150285207N00000X, 207ND0101X
CAA168460207N00000X
WI75308-20207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology