Panju Prithviraj, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

35-051822 Issued in OH

Practice address

615 Fulton St
Port Clinton, OH 43452

Phone

(419) 734-3131

Fax

(419) 732-4046

NPI assigned

Oct 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477647923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "43452",
            "telephone_number": "419-734-3131",
            "fax_number": "419-732-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "43452",
            "telephone_number": "419-734-3131",
            "fax_number": "419-732-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRITHVIRAJ",
        "first_name": "PANJU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35-051822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF OHIO",
            "identifier": "342850",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0585755",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Joseph Popson III
• Port Clinton City
• Port Clinton City Schools
• Beth Eileen Powers
• Cheryl Pratt
• Promedica Northwest Ohio Cardiology Consultants, LLC
• Psychological Transitions, Inc
• Quality Primary Care Corporation (Fastrack Urgent Care Corporation)
• Leonardo T Que, M.D.
• Virgie U Que, M.D.

• Hematology & Oncology Physician in Port Clinton, OH
• Providers in Port Clinton, OH by specialty
• Hematology & Oncology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.