Provider Demographics
NPI:1043388127
Name:SAHGAL, NAMITA (MD)
Entity type:Individual
Prefix:
First Name:NAMITA
Middle Name:
Last Name:SAHGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAMITA
Other - Middle Name:
Other - Last Name:SINGHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 MICHIGAN AVE
Mailing Address - Street 2:STE 330
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-1580
Mailing Address - Country:US
Mailing Address - Phone:574-753-4151
Mailing Address - Fax:574-722-1560
Practice Address - Street 1:1201 MICHIGAN AVE
Practice Address - Street 2:STE 330
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-1580
Practice Address - Country:US
Practice Address - Phone:574-753-4151
Practice Address - Fax:574-722-1560
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04 26738208000000X
IN01073246A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000841166OtherANTHEM
KY1043388127OtherFIRST HEALTH
IN201193720Medicaid
KS100278140DMedicaid
KS1043388127OtherUNICARE
KST11000001OtherMEDICARE INDIVIDUAL
KS1043388127OtherUNICARE
KST11000001OtherMEDICARE INDIVIDUAL