Provider Demographics
NPI:1366477424
Name:SINGH, SONU G (MD)
Entity type:Individual
Prefix:DR
First Name:SONU
Middle Name:G
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SONU
Other - Middle Name:GUPTA
Other - Last Name:KUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:604 S 8TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4214
Mailing Address - Country:US
Mailing Address - Phone:678-248-2899
Mailing Address - Fax:678-248-2897
Practice Address - Street 1:604 S 8TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4214
Practice Address - Country:US
Practice Address - Phone:678-248-2899
Practice Address - Fax:678-248-2897
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055026207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA621238915AMedicaid
GA39BDCKLMedicare ID - Type Unspecified
GAI23225Medicare UPIN