Basic Information
| Provider Information | |||||||||
| NPI: | 1639380926 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DHINGRA | ||||||||
| FirstName: | PANKAJ | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1260 SENTRY DR STE 140 | ||||||||
| Address2: | |||||||||
| City: | WAUKESHA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531865990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2625241024 | ||||||||
| FaxNumber: | 2625248767 | ||||||||
| Practice Location | |||||||||
| Address1: | 1260 SENTRY DR STE 140 | ||||||||
| Address2: | |||||||||
| City: | WAUKESHA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531865990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2625241024 | ||||||||
| FaxNumber: | 2625248767 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 12/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 57005667 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 50591 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.