Healthcare Provider Details

I. General information

NPI: 1235627027
Provider Name (Legal Business Name): REEMA SHAMSHER SINGH MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REEMA RAVISH MBBS

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CHANNING WAY
IDAHO FALLS ID
83404-7533
US

IV. Provider business mailing address

4561 E WIND RIVER DR
IDAHO FALLS ID
83401-5725
US

V. Phone/Fax

Practice location:
  • Phone: 208-227-2850
  • Fax:
Mailing address:
  • Phone: 562-396-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM-15608
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM-15608
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: