Pavan Brahmamdam
Pediatric Surgery
3535 W 13 Mile Rd # 307 Medical Office Building
Royal Oak
, Michigan 48073-6770
Pavan Brahmamdam
Pediatric Surgery
3535 W 13 Mile Rd # 307 Medical Office Building
Royal Oak
, Michigan 48073-6770
(248) 585-8266
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Pavan Brahmamdam
- 130 Town Center Dr Ste 203 Beaumont Medical Staff Affairs
- Troy, MI
- Zip : 48084-1744
- Fax : (248) 585-8266
- Phone : (248) 585-8218
Second Address
- Pavan Brahmamdam
- 3535 W 13 Mile Rd # 307 Medical Office Building
- Royal Oak, MI
- Zip : 48073-6770
- Fax : (248) 551-6556
- Phone : (248) 551-2400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 4301101193 | MI |
National Provider Identifier
| NPI | 1346444270 |
|---|---|
| Provider Name | Pavan Brahmamdam |
| First Address | Troy, MI 48084-1744 |
| Second Address | Royal Oak, MI 48073-6770 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/06/2007 |
| Last Update Date | 14/09/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| BP1-0022823 | INSTITUTIONAL PERMIT (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.