Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD20936 | ME |
NPI | 1265631352 |
---|---|
Provider Name | Dr. Kartikey A Pandya |
First Address | Portland, ME 04103-1073 |
Second Address | Portland, ME 04102-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2007 |
Last Update Date | 27/04/2017 |