Provider Demographics
NPI:1710120902
Name:PANDIT, APOORVA CHANDRAKANT
Entity Type:Individual
Prefix:
First Name:APOORVA
Middle Name:CHANDRAKANT
Last Name:PANDIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41488 PHEASANT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-5201
Mailing Address - Country:US
Mailing Address - Phone:734-397-9437
Mailing Address - Fax:
Practice Address - Street 1:1970 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-2297
Practice Address - Country:US
Practice Address - Phone:313-386-6330
Practice Address - Fax:313-383-4801
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist