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
Fax: (313) 562-8511
Website:

Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649240615 NPPES
Michigan MEDICAID 4600306

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