Provider Demographics
NPI:1275535403
Name:PANDEY, HEMANT K (MD)
Entity Type:Individual
Prefix:DR
First Name:HEMANT
Middle Name:K
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 1:4045 W CHANDLER BLVD BLDG F
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3732
Mailing Address - Country:US
Mailing Address - Phone:480-917-3706
Mailing Address - Fax:480-353-2066
Practice Address - Street 1:4045 W CHANDLER BLVD BLDG F
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3732
Practice Address - Country:US
Practice Address - Phone:480-917-3706
Practice Address - Fax:480-353-2066
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ420252084N0600X, 2084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ500621Medicaid
AZZ137357Medicare PIN
AZZ147509Medicare PIN
TXI09610Medicare UPIN
AZZ137357Medicare PIN