=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174632962
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARBHUR SINGH MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1020 INDEPENDENCE BLVD STE 213B
-----------------------------------------------------
City | VA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455-5542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-363-1948
-----------------------------------------------------
Fax | 757-363-8774
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1020 INDEPENDENCE BLVD STE 213B
-----------------------------------------------------
City | VA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455-5542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-363-1948
-----------------------------------------------------
Fax | 757-363-8774
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. PARBHUR SINGH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 757-363-1948
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 0101030667
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------