Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35045043 | OH |
Y | 208600000X | Surgeon | 35045043 | OH |
N | 2086S0122X | Plastic and Reconstructive Surgery | 35-045043 | OH |
NPI | 1275648792 |
---|---|
Provider Name | Dr. Vasu Pandrangi |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44130-3336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 15/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0444291 | (05) | OH |
A79834 | (02) | OH |