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NPI Code Detail

MEDICARE: PRADEEP K PANDYA M.D.

MEDICARE:   PRADEEP K PANDYA  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician35044049POH

General Provider Information

NPI Number : 1396721486
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRADEEP K PANDYA M.D.
Provider Business Mailing Address
First Line : 131 N EWING ST
Second Line : UNIT A
City : LANCASTER
State : OH
Zip : 43130-3383
Country : US
Telephone Number : 740-687-1247
Fax Number : 740-687-3594
Provider Business Practice Location Address
First Line : 131 N EWING ST
Second Line : UNIT A
City : LANCASTER
State : OH
Zip : 43130-3383
Country : US
Telephone Number : 740-687-1247
Fax Number : 740-687-3594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 07/08/2007

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Directions to “ PRADEEP K PANDYA M.D.” Practice Location

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