Healthcare Provider Details

I. General information

NPI: 1639757339
Provider Name (Legal Business Name): ANJANYA DEVENDRA SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 MEMORIAL DR
BELLEVILLE IL
62226-5360
US

IV. Provider business mailing address

PO BOX 959203
SAINT LOUIS MO
63195-4402
US

V. Phone/Fax

Practice location:
  • Phone: 618-257-6220
  • Fax: 618-257-6679
Mailing address:
  • Phone: 636-484-5277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036171186
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: