Healthcare Provider Details

I. General information

NPI: 1013986116
Provider Name (Legal Business Name): AMITABH SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 GREENVALLEY PKWY BUILDING 3 STE 312
HENDERSON NV
89014
US

IV. Provider business mailing address

PO BOX 30248
LAS VEGAS NV
89173-0248
US

V. Phone/Fax

Practice location:
  • Phone: 702-253-1173
  • Fax: 702-253-1468
Mailing address:
  • Phone: 702-852-6633
  • Fax: 702-991-7258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD421741
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number11964
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: