Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | LDR200247 | IN |
NPI | 1063918746 |
---|---|
Provider Name | Robinpreet Singh Pannu |
First Address | Indianapolis, IN 46228-6336 |
Second Address | Indianapolis, IN 46202-5149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2018 |
Last Update Date | 06/06/2020 |