Provider Demographics
NPI:1447269535
Name:VORA, PANKIL (MD)
Entity type:Individual
Prefix:
First Name:PANKIL
Middle Name:
Last Name:VORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2822 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-1279
Mailing Address - Country:US
Mailing Address - Phone:330-606-7680
Mailing Address - Fax:
Practice Address - Street 1:96 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1292
Practice Address - Country:US
Practice Address - Phone:330-923-0553
Practice Address - Fax:330-923-0556
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063680207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0903571Medicaid
0731164Medicare ID - Type Unspecified
OH0903571Medicaid