Provider Demographics
NPI:1023384708
Name:PRAMOTE TANSWAI, M.D. PC
Entity Type:Organization
Organization Name:PRAMOTE TANSWAI, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ PRESIDENT OF AN ORGANIZA
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAMOTE
Authorized Official - Middle Name:
Authorized Official - Last Name:TANSWAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-690-7093
Mailing Address - Street 1:785 N LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-4012
Mailing Address - Country:US
Mailing Address - Phone:248-690-7093
Mailing Address - Fax:248-690-7461
Practice Address - Street 1:785 N. LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-4012
Practice Address - Country:US
Practice Address - Phone:248-690-7093
Practice Address - Fax:248-690-7461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033656305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service