Dalwinderpal Singh Samra, MD
Individual provider Active NPI Internal Medicine Physician · Anderson, IN
NPI 1023345972 · NPPES record last updated Sep 25, 2012
Key facts
- NPI
- 1023345972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 01061542A (IN)
- Practice address
- 1547 Ohio Ave.
Anderson, IN 46016-5088 - Phone
- (609) 694-8566
- NPI assigned
- Nov 13, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01061542A | IN | MD | Internal Medicine Physician |
| 0101245863 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Madison County Community Health Centers, Inc. | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Madison County Community Health Centers Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101245863 | VA | |
| Internal Medicine Physician | 207R00000X | 01061542A | IN | Yes |
Addresses
Primary practice location
1547 Ohio Ave.
Anderson, IN 46016-5088
Mailing address
PO Box 349
Anderson, IN 46015-0349
Phone (765) 641-7499
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200979260 | Medicaid | IN |
Other providers in Anderson, IN
- Saint John'S Health System
- Saint Johns Health System
- Saint Johns Health System
- Lauren Saloh
- Sarah J Sampson
- Cassie Sams
- Denise Sanders
- Michelle Lee Sanford
- Henna Sangha
- Jaspreet Sangha
All providers in Anderson, IN · Internal Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.