Healthcare Provider Details

I. General information

NPI: 1952392839
Provider Name (Legal Business Name): ROBERT S SINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29355 NORTHWESTERN HWY STE 200
SOUTHFIELD MI
48034-1053
US

IV. Provider business mailing address

29355 NORTHWESTERN HWY STE 302
SOUTHFIELD MI
48034-1065
US

V. Phone/Fax

Practice location:
  • Phone: 248-353-0880
  • Fax: 248-353-3646
Mailing address:
  • Phone: 248-228-2990
  • Fax: 248-281-1764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301059442
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: