Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | D0083489 | MD |
NPI | 1063754125 |
---|---|
Provider Name | Dr. Prerna Raj Pandya |
First Address | Baltimore, MD 21224-2735 |
Second Address | Baltimore, MD 21224-2735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2013 |
Last Update Date | 29/11/2021 |