PAVAN BRAHMAMDAM (NPI# 1346444270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346444270 |
Entity Type | Individual |
Full Name | PAVAN BRAHMAMDAM |
Credential | MD |
Practice Address |
3535 W 13 Mile Rd # 307 Medical Office Building Royal Oak MI 48073-6770 |
Mailing Address |
130 Town Center Dr Ste 203 Beaumont Medical Staff Affairs Troy MI 48084-1744 |
Practice Telephone | 2485512400 |
Practice Fax Number | 2485516556 |
Mailing Telephone | 2485858218 |
Mailing Fax Number | 2485858266 |
Enumeration Date | 2007-06-13 |
Last Update Date | 2015-09-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
4301101193 | MI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
INSTITUTIONAL PERMIT | BP1-0022823 | 01 |
Street Address |
3535 W 13 MILE RD # 307 MEDICAL OFFICE BUILDING |
City | ROYAL OAK |
State | MI |
Zip Code | 48073-6770 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
Find all providers in zip 48073 |
Taxonomy Code | 2086S0120X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Pediatric Surgery |
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912967597 | Robert Morden | Surgery | 3535 W 13 Mile Rd, Ste. 748, Royal Oak, MI 48073-6710 | 2006-03-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235365081 | Elliot Carr Pennington | Surgery | 330 Barclay Ave Ne Ste 202, Grand Rapids, MI 49503-2525 | 2009-06-08 |
1700908423 | Susan Hershberg Adelman | Surgery | 29820 Woodland Dr, Southfield, MI 48034-1339 | 2007-04-04 |
1891742128 | Ajith K Kadakol | Surgery | 1701 South Blvd E Ste B75, Rochester Hills, MI 48307-6122 | 2006-05-30 |
1336147461 | Joseph Lawrence Lelli | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2005-07-12 |
1912322009 | Lakeshore Surgical Consultants, Plc | Surgery | 5400 Fort St, Suite 200, Trenton, MI 48183-4632 | 2014-02-26 |
1205197639 | Marcus P Haw | Surgery | 100 Michigan St Ne, 10th Floor, Mc 248, Grand Rapids, MI 49503-2560 | 2012-06-01 |
1346514254 | Masih Abdul Kader | Surgery | 3901 Beaubien St, Detroit, MI 48201-2119 | 2012-02-24 |
1114159415 | Daniel Joseph Watkins | Surgery | 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 | 2009-08-20 |
1730324096 | Lydia Joy Donoghue | Surgery | 3901 Beaubien St, Dept of Pediatric Surgery, Detroit, MI 48201-2119 | 2008-12-15 |
1194920041 | Justin D Klein | Surgery | 3901 Beaubien St, Carls Building 2nd Floor, Detroit, MI 48201-2119 | 2007-06-20 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.