MEDICARE: SUE ELLEN SINGH PA

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	363A00000X	Physician Assistant	101551	NC

General Provider Information

NPI Number	:	1891882635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUE ELLEN SINGH PA

Provider Business Mailing Address
First Line	:	2000 FRONTIS PLAZA BLVD STE 200
Second Line	:	NOVANT MEDICAL GROUP
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-5616
Country	:	US
Telephone Number	:	336-277-2435
Fax Number	:	336-277-9275

Provider Business Practice Location Address
First Line	:	5010 PETERS CREEK PKWY
Second Line	:	DBA FRIEDBERG FAMILY MEDICINE
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-7276
Country	:	US
Telephone Number	:	336-788-4664
Fax Number	:	336-788-0753

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	10/28/2020

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Directions to “ SUE ELLEN SINGH PA” Practice Location

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