MEDICARE: DR. INDERJIT SINGH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	112064	MO
2	174400000X	Specialist	036-090622	IL
3	207RN0300X	Nephrology Physician	036-090622	IL
4	207RN0300X	Nephrology Physician	112064	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	390008089	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	115370	OTHER	MO	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	37151	OTHER	MO	CMR
4	103507	OTHER	MO	GHP
5	3100060	OTHER	MO	UNITED HEALTH CARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	279894	OTHER	MO	HEALTHLINK

General Provider Information

NPI Number	:	1609842434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INDERJIT SINGH MD

Provider Business Mailing Address
First Line	:	PO BOX 1125
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-0125
Country	:	US
Telephone Number	:	314-432-2580
Fax Number	:	314-432-0223

Provider Business Practice Location Address
First Line	:	11155 DUNN RD
Second Line	:	SUITE 207N
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6149
Country	:	US
Telephone Number	:	314-736-6590
Fax Number	:	314-736-4359

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	03/10/2022

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Directions to “ DR. INDERJIT SINGH MD” Practice Location

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