MEDICARE: DR. BRAJENDRA P SINGH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	28805	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	010018498	OTHER	NC	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60018905	OTHER	NC	TAT NUMBER
2	76548	OTHER	NC	BCBS
4	34D0245916	OTHER	NC	CLIA NUMBER
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235122649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAJENDRA P SINGH MD

Provider Business Mailing Address
First Line	:	311 S MCNEIL ST
Second Line	:	PO BOX 1299
City	:	BURGAW
State	:	NC
Zip	:	28425-5015
Country	:	US
Telephone Number	:	910-259-3377
Fax Number	:	910-259-3013

Provider Business Practice Location Address
First Line	:	311 S MCNEIL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5015
Country	:	US
Telephone Number	:	910-259-3377
Fax Number	:	910-259-3013

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	08/11/2011

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