Pavani Kolli, MD PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PAVANI KOLLI, MD PLC

Practice address

24604 Michigan Ave
Dearborn, MI 48124-1742

Phone

(313) 908-9374

Fax

(313) 562-8511

NPI assigned

Jan 31, 2006

Organization subpart

No

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

Authorized official

Name

Pavani Kolli, M.D.NPI 1649240615

Title

President

Phone

(734) 266-2780

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pavani Kolli, MD

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1649240615
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1467423194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24604 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241742",
            "telephone_number": "313-908-9374",
            "fax_number": "313-562-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24604 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241742",
            "telephone_number": "313-908-9374",
            "fax_number": "313-562-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVANI KOLLI, MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "KOLLI",
        "authorized_official_first_name": "PAVANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-266-2780",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shailes Paudel, MBBS
• Paul F. Goerke D.O. PC
• Christine Paul, AU.D
• Merilyn Paul
• Amanda Paulus, DO
• Joanna Noelle Pavel, LPC
• Layla Rose Pavlick
• Geraldine L Pawlik, M.D.
• Brianne Nicole Payne
• Diamond Charveon Payne

• Internal Medicine Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.