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General NPI Number Information
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NPI Number | 1326539248
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Entity Type | Individual
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Provider Name | PRIYANKA PANDEY DO
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Gender | Female
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 11800 E 12 MILE RD
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City | WARREN
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State | MI
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Zip | 48093-3472
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Country | US
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Telephone | 586-576-1615
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Fax | 855-856-4154
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Provider Business Mailing Address
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Address Line | 17125 W 14 MILE RD
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-3225
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Country | US
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Telephone | 248-417-6625
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 5101027177
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 6052
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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