Provider Demographics
NPI:1710567482
Name:SINGH, GAGANDEEP
Entity type:Individual
Prefix:
First Name:GAGANDEEP
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 N ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-0059
Mailing Address - Country:US
Mailing Address - Phone:317-880-2900
Mailing Address - Fax:
Practice Address - Street 1:1660 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-0059
Practice Address - Country:US
Practice Address - Phone:317-880-2900
Practice Address - Fax:317-554-5735
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02007729A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine