Individual
MR. PRAVIN P PURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1080 KIRTS BLVD, SUITE 700, TROY, MI 48084-4881
(248) 362-2300
(248) 362-5272
Mailing address
1080 KIRTS BLVD, SUITE 700, TROY, MI 48084-4881
(248) 362-2300
(248) 362-5272
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
4301059966
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4219899
—
MI
Enumeration date
12/05/2005
Last updated
09/05/2011
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