Basic Information
| Provider Information | |||||||||
| NPI: | 1417977083 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGH | ||||||||
| FirstName: | DEEPJOT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 309 E FARWELL RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992188205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152653300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 50 LEROY ST | ||||||||
| Address2: | |||||||||
| City: | POTSDAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152653300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | MD61194654 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 000000539603 | 01 | OH | ANTHEM | OTHER | P00250204 | 01 | OH | RAILROAD MEDICARE | OTHER | 000000229162 | 01 | OH | UNISON | OTHER | 2511295 | 05 | OH | MEDICAID | 364019 | 01 | OH | WELLCARE | OTHER | 741835 | 01 | OH | BUCKEYE | OTHER | 7591698 | 01 | OH | AETNA | OTHER | P00449232 | 01 | OH | RAILROAD MEDICARE | OTHER |