Provider Demographics
NPI:1952358798
Name:DIGESTIVE AND LIVER DISEASE
Entity Type:Organization
Organization Name:DIGESTIVE AND LIVER DISEASE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KESHAV
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-755-7794
Mailing Address - Street 1:10 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4435
Mailing Address - Country:US
Mailing Address - Phone:508-755-7794
Mailing Address - Fax:508-755-7070
Practice Address - Street 1:10 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4435
Practice Address - Country:US
Practice Address - Phone:508-755-7794
Practice Address - Fax:508-755-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37367207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA207RG0100XOtherTAXONOMY NUMBER
MA2045192Medicaid
MA207RG0100XOtherTAXONOMY NUMBER
MA207RG0100XOtherTAXONOMY NUMBER