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Individual

PANKAJ K DAVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1543 FORD AVE, WYANDOTTE, MI 48192-2303
(734) 282-5012
(734) 282-7428
Mailing address
1543 FORD AVE, WYANDOTTE, MI 48192-2303
(734) 282-5012
(734) 282-7428

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
PD035475
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0824411
BCBSM
MI
05
1398464
MI
01
A78410
HAP
MI
Enumeration date
09/27/2006
Last updated
07/08/2007
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