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General NPI Number Information
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NPI Number | 1932203023
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Entity Type | Organization
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Legal Business Name | SOUTH WEST NEPHROLOGY LLC
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8523 RIDGE RD
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City | NO ROYALTON
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State | OH
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Zip | 44133-1856
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Country | US
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Telephone | 440-237-7112
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Fax | 440-237-1406
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Provider Business Mailing Address
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Address Line | 8523 RIDGE RD
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City | NO ROYALTON
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State | OH
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Zip | 44133-1856
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Country | US
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Telephone | 440-237-7112
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Fax | 440-237-1406
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Authorized Official
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Title or Position | PARTNER OWNER
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Name | KULBIR S PANNU
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Credential | MD
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Telephone | 440-237-7112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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