Provider Demographics
NPI:1033370739
Name:SAWAL, PANKAJ MOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PANKAJ
Middle Name:MOHAN
Last Name:SAWAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 183787
Mailing Address - Street 2:C/O AT HOME PHYSICAN MANAGING COMPANY
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48318-3787
Mailing Address - Country:US
Mailing Address - Phone:877-897-7477
Mailing Address - Fax:877-755-1030
Practice Address - Street 1:3771 E 10 MILE RD
Practice Address - Street 2:C/O AT HOME PHYSICAN MANAGING COMPANY
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-3722
Practice Address - Country:US
Practice Address - Phone:877-897-7477
Practice Address - Fax:877-755-1030
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2012-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI4301092697207Q00000X
WAMD 60291304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine