Provider Demographics
NPI:1669630877
Name:PAWAR, SANJEEV MADHAV (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJEEV
Middle Name:MADHAV
Last Name:PAWAR
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 1:6152 220TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2245
Mailing Address - Country:US
Mailing Address - Phone:347-751-2924
Mailing Address - Fax:
Practice Address - Street 1:2525 E CAMELBACK RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4219
Practice Address - Country:US
Practice Address - Phone:602-778-3667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXIN PROCESS207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine