Provider Demographics
NPI:1164643441
Name:MANMOHAN SINGH MD PA
Entity type:Organization
Organization Name:MANMOHAN SINGH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC
Authorized Official - Prefix:
Authorized Official - First Name:JYOTI
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:919-934-2616
Mailing Address - Street 1:PO BOX 1196
Mailing Address - Street 2:713 NORTH ST
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577
Mailing Address - Country:US
Mailing Address - Phone:919-934-2626
Mailing Address - Fax:919-934-5424
Practice Address - Street 1:713 NORTH STREET
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577
Practice Address - Country:US
Practice Address - Phone:919-934-2626
Practice Address - Fax:919-934-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17900208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC76547OtherBCBS
NC8976547Medicaid
NC201453Medicare ID - Type Unspecified
NC76547OtherBCBS