Sreedhar Paknikar, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301040155 Issued in MI

Practice address

1321 Stone St
Port Huron, MI 48060-3520

Phone

(810) 984-1000

Fax

(810) 984-3138

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1164498234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 STONE ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603520",
            "telephone_number": "810-984-1000",
            "fax_number": "810-984-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 STONE ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603520",
            "telephone_number": "810-984-1000",
            "fax_number": "810-984-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKNIKAR",
        "first_name": "SREEDHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301040155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164498234",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tricia Ott
• Otto Bock Patient Care, LLC
• Kris Alan Overly, D.D.S.
• Joanne Owens, RPH
• Cortney Layne Paddock, LMSW
• Norma Pakulski, LMT, LPN
• Skye L Paling, LLBSW
• Glowill Pambid
• Heather Panczyk
• Kevin R Papenfus

• Pediatrics Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.