Healthcare Provider Details

I. General information

NPI: 1326073594
Provider Name (Legal Business Name): PARAG ARUNKUMAR PANDYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 S MAIN ST
DANVILLE VA
24541-2922
US

IV. Provider business mailing address

PO BOX 2644
BIRMINGHAM AL
35202-2644
US

V. Phone/Fax

Practice location:
  • Phone: 434-799-2375
  • Fax:
Mailing address:
  • Phone: 205-322-1808
  • Fax: 205-322-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101232177
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number0101232177
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: