Healthcare Provider Details

I. General information

NPI: 1619137601
Provider Name (Legal Business Name): URMIL B PANDYA M D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 01/05/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S GRANT AVE TRAUMA SERVICES
COLUMBUS OH
43215-4701
US

IV. Provider business mailing address

5450 FRANTZ RD STE 360
DUBLIN OH
43016-4141
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-9489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number35.090070
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: