Organization Name: | PANKAJ VAKHARIA MD PLLC |
NPI Number: | 1275706434 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PANKAJ N. VAKHARIA (OWNER / PRESIDENT) |
Mailing Address: | 15224 Apollo Drive Holly |
State: | MI US |
Postal Code: | 484421166 |
Phone Number: | 2483284000 |
Fax Number: | 2483281304 |
NPI Enumeration Date: | 04/09/2008 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | PV033669 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |