Provider Demographics
NPI:1114157351
Name:PANDEY, PARITOSH (MD)
Entity Type:Individual
Prefix:DR
First Name:PARITOSH
Middle Name:
Last Name:PANDEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2791 SOMERSET BLVD
Mailing Address - Street 2:APTT NO 109
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4011
Mailing Address - Country:US
Mailing Address - Phone:248-686-4390
Mailing Address - Fax:
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:SUITE 6E
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:248-686-4390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093448207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery