Provider Demographics
NPI:1760749600
Name:PANDHI, SHASHWAT (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SHASHWAT
Middle Name:
Last Name:PANDHI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 INDIAN SCHOOL RD NE STE 143
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3176
Mailing Address - Country:US
Mailing Address - Phone:505-542-4970
Mailing Address - Fax:505-213-6301
Practice Address - Street 1:6121 INDIAN SCHOOL RD NE STE 143
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3176
Practice Address - Country:US
Practice Address - Phone:505-542-4970
Practice Address - Fax:505-213-6301
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2020-05922084P0800X, 2084P0804X, 2084P0802X, 2084P0804X
PAMD4581272084P0802X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty