Provider Demographics
NPI:1538329560
Name:PANDIT, TRAILOKYA NATH (MD)
Entity Type:Individual
Prefix:DR
First Name:TRAILOKYA
Middle Name:NATH
Last Name:PANDIT
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 1:302 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-6132
Mailing Address - Country:US
Mailing Address - Phone:810-762-8400
Mailing Address - Fax:810-762-8118
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 130
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0916
Practice Address - Country:US
Practice Address - Phone:404-425-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT51040207R00000X, 208M00000X
PAMD440546207R00000X
CODR.0056636207RH0003X
MI4301102451207RH0003X
GA88901207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80250050Medicaid