Healthcare Provider Details

I. General information

NPI: 1861465296
Provider Name (Legal Business Name): SARITA SINGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 11/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 MOUNT FOREST BOULEVARD
THUNDER BAY ONTARIO
P7J1H6
CA

IV. Provider business mailing address

2044 MOUNT FOREST BOULEVARD
THUNDER BAY ONTARIO
P7J1H6
CA

V. Phone/Fax

Practice location:
  • Phone: 18074738390
  • Fax:
Mailing address:
  • Phone: 18074738390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number72363
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: