Provider Demographics
NPI:1730147190
Name:SINGH, SURJIT KAUR (MD)
Entity type:Individual
Prefix:
First Name:SURJIT
Middle Name:KAUR
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10560 MAIN ST
Mailing Address - Street 2:SUITE #215 MOSBY BUILDING
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7182
Mailing Address - Country:US
Mailing Address - Phone:571-432-0700
Mailing Address - Fax:571-432-0330
Practice Address - Street 1:10560 MAIN ST
Practice Address - Street 2:SUITE #215 MOSBY BUILDING
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7182
Practice Address - Country:US
Practice Address - Phone:571-432-0700
Practice Address - Fax:571-432-0330
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE10352Medicare UPIN