Organization
PANKAJ VAKHARIA MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PANKAJ N. VAKHARIA M.D. (OWNER / PRESIDENT)
(248) 328-4000
Entity
Organization
Contact information
Practice address
15224 APOLLO DRIVE, HOLLY, MI 48442-1166
(248) 328-4000
(248) 328-1304
Mailing address
3547 INVERNESS DRIVE, ROCHESTER, MI 48306-4757
(248) 328-4000
(248) 328-1304
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
PV033669
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110203900
R.R. MEDICARE
MI
01
—
1106338622
BCBSM
MI
01
—
1144302
HEALTHPLUS
MI
01
—
4217778
MEDICAID, FLINT
MI
05
—
4217820
—
MI
01
—
PV033669
LICENSE
MI
Enumeration date
04/09/2008
Last updated
03/29/2016
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