Individual
PRATIVA PANDEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 S HOSPITAL DR, MURPHYSBORO, IL 62966-3333
(618) 684-3156
(618) 684-1040
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 684-3156
(618) 684-1040
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
036.151303
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214881
MULTI SPECIALTY GROUP PTAN
IL
Enumeration date
05/04/2017
Last updated
05/12/2021
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