Brahmamdam, Pavan
Brahmamdam, Pavan is an individual health care provider with primary practice located at 3535 W 13 Mile Rd Ste 307 , Royal Oak MI 48073-6770. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Pediatric Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Brahmamdam, Pavan can be contacted via phone (248) 551-2400.Contact Information
Primary practice address
3535 W 13 Mile Rd Ste 307
Royal Oak MI 48073-6770
Phone: (248) 551-2400
Fax: (248) 551-6556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 4301101193 | Michigan |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 4301101193 | Michigan |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4301101193 | Michigan |
Profile Details
| NPI number | 1346444270 |
|---|---|
| LBN Legal business name | Brahmamdam, Pavan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2007 |
| Last updated | Oct 24th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346444270 | NPPES |
| Other | BP1-0022823 | INSTITUTIONAL PERMIT |
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