Healthcare Provider Details

I. General information

NPI: 1659574630
Provider Name (Legal Business Name): NEENA SINGH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 4TH ST SW SUITE 330
MASON CITY IA
50401-2857
US

IV. Provider business mailing address

621 S ILLINOIS AVE SUITE 103
MASON CITY IA
50401-5405
US

V. Phone/Fax

Practice location:
  • Phone: 641-428-7951
  • Fax: 641-428-7269
Mailing address:
  • Phone: 641-428-3041
  • Fax: 641-428-3059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number40284
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberE-4234
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: