Provider Demographics
NPI:1982796132
Name:PANNU, AMARJIT K (MD)
Entity type:Individual
Prefix:
First Name:AMARJIT
Middle Name:K
Last Name:PANNU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9312 RED TWIG DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-1810
Mailing Address - Country:US
Mailing Address - Phone:702-639-3540
Mailing Address - Fax:702-639-3542
Practice Address - Street 1:9312 RED TWIG DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-1810
Practice Address - Country:US
Practice Address - Phone:702-639-3540
Practice Address - Fax:702-639-3542
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7247208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics