Individual
PANJU PRITHVIRAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 FULTON ST, PORT CLINTON, OH 43452
(419) 734-3131
(419) 732-4046
Mailing address
615 FULTON ST, PORT CLINTON, OH 43452
(419) 734-3131
(419) 732-4046
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35-051822
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0585755
—
OH
01
—
342850
ANTHEM BCBS OF OHIO
OH
Enumeration date
10/02/2006
Last updated
07/08/2007
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