Organization
OUTPATIENT ENDOSCOPY & SURGI CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARIVALLABH D PANDYA M.D. (PRESIDENT)
(586) 778-6090
Entity
Organization
Contact information
Practice address
28300 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1686
(586) 778-6090
(586) 778-1943
Mailing address
28300 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1686
(586) 778-6090
(586) 778-1943
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
506821
MI
261QE0800X
Endoscopy Clinic/Center
506821
MI
Other
Enumeration date
03/27/2007
Last updated
09/11/2025
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