Individual
PURUSHOTTAM V PANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 BROAD AVE, SUITE 270, GULFPORT, MS 39501-2404
(228) 575-1234
(228) 575-1240
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 575-1234
(228) 575-1240
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
11683
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013335
—
MS
Enumeration date
12/19/2005
Last updated
07/10/2014
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