| Pando Partners Healthcare Services & Innovative Solutions, Sc | |
|
5300 W Villard Ave Milwaukee WI 53218-4345 | |
| (414) 438-6666 | |
| (414) 438-6667 |
| Full Name | Pando Partners Healthcare Services & Innovative Solutions, Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5300 W Villard Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Khalil Odeh (PRESIDENT) |
| Authorized Official Contact | 4147790655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pando Partners Healthcare Services & Innovative Solutions, Sc 5300 W Villard Ave Milwaukee WI 53218-4345 Ph: (414) 438-6666 | Pando Partners Healthcare Services & Innovative Solutions, Sc 5300 W Villard Ave Milwaukee WI 53218-4345 Ph: (414) 438-6666 |
| NPI Number | 1720771421 |
|---|---|
| Provider Enumeration Date | 05/30/2023 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 4385006006 |
|---|---|
| Medicare Enrollment ID | O20230811003290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720771421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Champalal Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962418236 PECOS PAC ID: 7416938923 Enrollment ID: I20040528000796 |
| Provider Name | Aymen M Khogali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689851412 PECOS PAC ID: 6507916699 Enrollment ID: I20090611000285 |
| Provider Name | Anatoliy Velikodanov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740423441 PECOS PAC ID: 0042362584 Enrollment ID: I20090715000155 |
| Provider Name | Khalil H Odeh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952832131 PECOS PAC ID: 0941629034 Enrollment ID: I20200923000129 |
| Provider Name | Hassan Homida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073017695 PECOS PAC ID: 3779977103 Enrollment ID: I20230309000752 |
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