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PURUSHOTTAM V PANDE MD NPI 1619953072


NPI Information

NPI: 1619953072
Provider Name: PURUSHOTTAM V PANDE, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

PECOS Registration: Yes

Address:
1340 BROAD AVE
SUITE 270
GULFPORT, MS
ZIP 39501
Phone: (228) 575-1234
Get Directions

Purushottam V Pande, MD is a hematology and oncology internal medicine in Gulfport, MS with 49 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Purushottam V Pande, MD NPI is 1619953072. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1340 BROAD AVE
SUITE 270
GULFPORT, MS
ZIP 39501-404
Phone: (228) 575-1234
Fax: (228) 575-1240

The NPI 1619953072 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/19/2005 and was last updated on 7/10/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & Oncology11683MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100013335MEDICAIDMISSISSIPPI
2302I905484MEDICARE PINMISSISSIPPI
3B30978MEDICARE UPIN
4110000490MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.