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General NPI Number Information
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NPI Number | 1083660393
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Entity Type | Organization
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Legal Business Name | PANKAJ HUKKU, MD PC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 1380 COOLIDGE HWY STE 110
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City | TROY
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State | MI
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Zip | 48084-7067
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Country | US
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Telephone | 248-280-1867
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Fax | 248-280-0222
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Provider Business Mailing Address
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Address Line | PO BOX 2502
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City | BIRMINGHAM
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State | MI
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Zip | 48012-2502
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Country | US
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Telephone | 248-212-6442
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Fax | 248-280-0222
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Authorized Official
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Title or Position | OWNER
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Name | DR. PANKAJ HUKKU
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Credential | MD
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Telephone | 248-280-1867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 4301047842
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License Number State | MI
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