Healthcare Provider Details

I. General information

NPI: 1942432414
Provider Name (Legal Business Name): BIBHAS SINGLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15146 16TH AVE
MARNE MI
49435-9605
US

IV. Provider business mailing address

15146 16TH AVE
MARNE MI
49435-9605
US

V. Phone/Fax

Practice location:
  • Phone: 844-776-9651
  • Fax: 616-341-6016
Mailing address:
  • Phone: 877-776-9651
  • Fax: 616-341-6017

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 State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301103765
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number54265
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: