Individual
PREM P SIWAKOTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6599 E BROAD ST, COLUMBUS, OH 43213-1509
(614) 986-7752
Mailing address
6599 E BROAD ST, COLUMBUS, OH 43213-1509
(614) 986-7752
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.007511RX
OH
Other
Enumeration date
03/01/2022
Last updated
03/25/2023
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