Provider Demographics
NPI:1164274809
Name:PANAKKAL, VANDANA (MBBS,MD)
Entity Type:Individual
Prefix:
First Name:VANDANA
Middle Name:
Last Name:PANAKKAL
Suffix:
Gender:F
Credentials:MBBS,MD
Other - Prefix:
Other - First Name:VANDANA
Other - Middle Name:
Other - Last Name:P
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS,MD
Mailing Address - Street 1:3600 FORBES AVENUE
Mailing Address - Street 2:FORBES TOWER - PLAZE LEVEL SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3550 TERRACE STREET, UNIVERSITY OF PITTSBURGH MEDICAL C
Practice Address - Street 2:A711 SCAIFE HALL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261
Practice Address - Country:US
Practice Address - Phone:412-802-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT230345390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program