Provider Demographics
NPI:1144621277
Name:PAWAR, PRACHI R (MD)
Entity type:Individual
Prefix:
First Name:PRACHI
Middle Name:R
Last Name:PAWAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRACHI
Other - Middle Name:ULHAS
Other - Last Name:KALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:1180 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5863
Mailing Address - Country:US
Mailing Address - Phone:307-212-7570
Mailing Address - Fax:307-212-7530
Practice Address - Street 1:1180 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5863
Practice Address - Country:US
Practice Address - Phone:307-212-7570
Practice Address - Fax:307-212-7530
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WY13202A2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program