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Individual

HARESH PANDYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
479 LAFAYETTE ST, IONIA, MI 48846
(616) 527-4200
(616) 527-5731
Mailing address
479 LAFAYETTE ST, IONIA, MI 48846
(616) 527-4200
(616) 527-5731

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
HP038801
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02630
P HEALTH PAY TO
MI
01
1003025
MCLAREN
MI
01
1832183
MOLINA
MI
01
200000000595
PHPMM
MI
Enumeration date
10/03/2006
Last updated
08/17/2007
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