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General NPI Number Information
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NPI Number | 1164639985
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Entity Type | Individual
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Provider Name | DURGA K PAI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 101 W UNIVERSITY AVE
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City | CHAMPAIGN
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State | IL
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Zip | 61820-3909
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Country | US
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Telephone | 217-366-1285
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W UNIVERSITY AVE
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City | CHAMPAIGN
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State | IL
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Zip | 61820-3909
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Country | US
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Telephone | 217-366-1285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 01068868
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 125-046842
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01068868
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License Number State | IN
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