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Contact Information

VEENA PANTHANGI, MD
21099 MASONIC BLVD
SAINT CLAIR SHORES, MI48082-1045
 Phone: 586-296-6213
 Fax: 586-286-8180
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for VEENA PANTHANGI · (Female)

NPI # 1467571463
Status Active
Credentials MD
Entity Individual
Enumeration date 03/29/2007
Last updated 03/26/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301081639
  • MI Medicaid 5186442
  • MI Other 700E031610 BCBS GROUP NUMBER
  • MI Other 700E011730 BCBSM GROUP NUMBER
  • MI Other VP081639 MICHIGAN PHYSICIAN LICENS
Hospital affiliation(s)
  • ST JOHN HOSPITAL AND MEDICAL CENTER - (Acute Care)
    22101 MOROSS RD
    DETROIT, MI 48236
  • ST JOHN MACOMB-OAKLAND HOSPITAL-MACOMB CENTER - (Acute Care)
    11800 EAST TWELVE MILE ROAD
    WARREN, MI 48093
  • WILLIAM BEAUMONT HOSPITAL - (Acute Care)
    3601 W THIRTEEN MILE RD
    ROYAL OAK, MI 48073
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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