Provider Demographics
NPI:1447327747
Name:PANIA, VIMLA D (MD)
Entity type:Individual
Prefix:DR
First Name:VIMLA
Middle Name:D
Last Name:PANIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7225 OLD OAK BLVD
Mailing Address - Street 2:B309
Mailing Address - City:MIDDLEBURG HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130
Mailing Address - Country:US
Mailing Address - Phone:440-234-3520
Mailing Address - Fax:440-234-9232
Practice Address - Street 1:7225 OLD OAK BLVD
Practice Address - Street 2:B309
Practice Address - City:MIDDLEBURG HTS
Practice Address - State:OH
Practice Address - Zip Code:44130
Practice Address - Country:US
Practice Address - Phone:440-234-3520
Practice Address - Fax:440-234-9232
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH036899207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000001581OtherANTHEM
A75517Medicare UPIN
0419051Medicare ID - Type Unspecified