Healthcare Provider Details

I. General information

NPI: 1063517415
Provider Name (Legal Business Name): ALBEMARLE PULMONARY MEDICINE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 NORTH ROAD STREET SUITE 1
ELIZABETH CITY NC
27909
US

IV. Provider business mailing address

1507 NORTH ROAD STREET SUITE 1
ELIZABETH CITY NC
27909
US

V. Phone/Fax

Practice location:
  • Phone: 252-338-6167
  • Fax: 252-334-1755
Mailing address:
  • Phone: 252-338-6167
  • Fax: 252-334-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33893
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number33893
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number33893
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number33893
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number33893
License Number StateNC

VIII. Authorized Official

Name: DR. JASVINDER PAL SINGH
Title or Position: PRESIDENT
Credential: MD
Phone: 252-338-6167