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NPI Code Detail

MEDICARE: DR. PANKAJ MOHAN SAWAL M.D.

MEDICARE:  DR. PANKAJ MOHAN SAWAL  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician4301092697MI
2207Q00000XFamily Medicine PhysicianMD 60291304WA

General Provider Information

NPI Number : 1033370739
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PANKAJ MOHAN SAWAL M.D.
Provider Business Mailing Address
First Line : PO BOX 183787
Second Line : C/O AT HOME PHYSICAN MANAGING COMPANY
City : SHELBY TOWNSHIP
State : MI
Zip : 48318-3787
Country : US
Telephone Number : 877-897-7477
Fax Number : 877-755-1030
Provider Business Practice Location Address
First Line : 3771 E 10 MILE RD
Second Line : C/O AT HOME PHYSICAN MANAGING COMPANY
City : WARREN
State : MI
Zip : 48091-3722
Country : US
Telephone Number : 877-897-7477
Fax Number : 877-755-1030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2008
Last Update Date : 10/23/2012

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