Provider Demographics
NPI:1417071374
Name:PANDHI, NIKHIL GAUTAM (DO)
Entity Type:Individual
Prefix:DR
First Name:NIKHIL
Middle Name:GAUTAM
Last Name:PANDHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:759 45TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2938
Mailing Address - Country:US
Mailing Address - Phone:219-836-0296
Mailing Address - Fax:219-836-0570
Practice Address - Street 1:759 45TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2938
Practice Address - Country:US
Practice Address - Phone:219-836-0296
Practice Address - Fax:219-836-0570
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016280207X00000X
IN99047928207XX0005X
IN02003901A207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery