Healthcare Provider Details

I. General information

NPI: 1316157795
Provider Name (Legal Business Name): JANU OLIVIA SINGH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANU SINGH BOHRA DO

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 SIMMONS LOOP
RIVERVIEW FL
33578-9498
US

IV. Provider business mailing address

6901 SIMMONS LOOP
RIVERVIEW FL
33578-9498
US

V. Phone/Fax

Practice location:
  • Phone: 248-895-1052
  • Fax:
Mailing address:
  • Phone: 248-895-1052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number036117971
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number02003295A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: