Kolli, Pavani
Kolli, Pavani is an individual health care provider with primary practice located at 24604 Michigan Ave , Dearborn MI 48124-1742. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Kolli, Pavani can be contacted via phone (313) 908-9374.Contact Information
Primary practice address
24604 Michigan Ave
Dearborn MI 48124-1742
Phone: (313) 908-9374
Fax: (313) 562-8511
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301074415 | Michigan |
Profile Details
| NPI number | 1649240615 |
|---|---|
| LBN Legal business name | Kolli, Pavani |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Sep 5th, 2008 - about 17 years ago |
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 | 1649240615 | NPPES |
| Michigan | MEDICAID | 4600306 |
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