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General NPI Number Information
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NPI Number | 1225347131
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Entity Type | Organization
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Legal Business Name | PRADEEP K PANDYA MD INC
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 131 N EWING ST SUITE A
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City | LANCASTER
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State | OH
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Zip | 43130-3383
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Country | US
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Telephone | 740-687-1247
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Fax | 740-687-3594
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Provider Business Mailing Address
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Address Line | 131 N EWING ST SUITE A
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City | LANCASTER
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State | OH
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Zip | 43130-3383
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Country | US
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Telephone | 740-687-1247
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Fax | 740-687-3594
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRADEEP K PANDYA
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Credential | M.D.
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Telephone | 740-687-1247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35044049
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License Number State | OH
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