MEDICARE: TATSIANA SINGH PA-C

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	363A00000X	Physician Assistant	0010-00353	NC
2	363A00000X	Physician Assistant	0110006517	VA

General Provider Information

NPI Number	:	1669542395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATSIANA SINGH PA-C

Provider Business Mailing Address
First Line	:	5667 BISON LN
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47802-8169
Country	:	US
Telephone Number	:	630-388-1740
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 LOWER DALLAS HWY
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034-9368
Country	:	US
Telephone Number	:	704-874-0200
Fax Number	:	704-874-0201

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	10/08/2019

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Directions to “ TATSIANA SINGH PA-C” Practice Location

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