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Individual

DR. PANKAJ SRIVASTAVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1445 US HIGHWAY 51 BYP E, SUITE C, DYERSBURG, TN 38024-2127
(731) 286-1900
(731) 286-1939
Mailing address
1445 US HIGHWAY 51 BYP E, DYERSBURG, TN 38024-2127
(731) 286-1900
(731) 286-1939

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD34709
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000118807
BETTER HEALTH
05
3862247
TN
01
4012046
BC
01
62-1815075
OMNI
Enumeration date
08/09/2005
Last updated
10/03/2014
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