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NPI Code Detail

MEDICARE: DR. AMANDA PANNU MD

MEDICARE: DR. AMANDA PANNU MD
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
1207Q00000XFamily Medicine Physician35.133556OH

General Provider Information

NPI Number : 1922427616
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA PANNU MD
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-2700
Fax Number : 614-293-2720
Provider Business Practice Location Address
First Line : 2231 N HIGH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-1115
Country : US
Telephone Number : 614-293-2700
Fax Number : 614-293-2720
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2014
Last Update Date : 04/16/2026

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