MEDICARE: DR. PAVEN UPPAL DO

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
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	5101029001	MI
2	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician	510129001	MI
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1336763283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAVEN UPPAL DO

Provider Business Mailing Address
First Line	:	24 FRANK LLOYD WRIGHT DRIVE
Second Line	:	SUITE J2000
City	:	ANN ARBOR
State	:	MI
Zip	:	48105
Country	:	US
Telephone Number	:	734-747-6766
Fax Number	:

Provider Business Practice Location Address
First Line	:	IHA PALLIATIVE CARE
Second Line	:	5301 E HURON RIVER DRIVE SUITE 2119
City	:	YPSILANTI
State	:	MI
Zip	:	48197
Country	:	US
Telephone Number	:	734-712-7255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2020
Last Update Date	:	12/15/2025

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