Provider Demographics
NPI:1386155521
Name:ZANESVILLE VASCULAR VEIN & WOUND CENTER LLC
Entity type:Organization
Organization Name:ZANESVILLE VASCULAR VEIN & WOUND CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RAJMONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PANNU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-917-0696
Mailing Address - Street 1:3964 FRAZEYSBURG RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-8920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3964 FRAZEYSBURG RD UNIT A
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-8920
Practice Address - Country:US
Practice Address - Phone:614-917-0696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty