Provider Demographics
NPI:1144885740
Name:SINGH, DILTAJ (DPM)
Entity type:Individual
Prefix:DR
First Name:DILTAJ
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18922 SHROPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8494
Mailing Address - Country:US
Mailing Address - Phone:703-902-0440
Mailing Address - Fax:
Practice Address - Street 1:21430 CEDAR DR STE 211
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-8697
Practice Address - Country:US
Practice Address - Phone:703-902-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0103301352213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program