Surinder K Singal
Individual provider Active NPI Pharmacist · Deale, MD
NPI 1164063210 · NPPES record last updated Sep 30, 2019
Key facts
- NPI
- 1164063210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 08093 (MD)
- Practice address
- 5809 Deale Churchton Rd
Deale, MD 20751-2203 - Phone
- (410) 867-2455
- Fax
- (410) 867-2466
- NPI assigned
- Sep 30, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201106000163 | MD | Practitioner - Mass Immunization Roster Biller | 1850701657 | Practice locations: Deale, MD |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08093 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deale Pharmacy LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 08093 | MD | Yes |
Addresses
Primary practice location
5809 Deale Churchton Rd
Deale, MD 20751-2203
Mailing address
5809 Deale Churchton Rd
Deale, MD 20751-2203
Phone (410) 867-2455
Other providers in Deale, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.