Provider Demographics
NPI:1275751844
Name:PANNU, SONAL RAJMONY (MBBS)
Entity Type:Individual
Prefix:
First Name:SONAL
Middle Name:RAJMONY
Last Name:PANNU
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-4925
Mailing Address - Fax:614-293-5503
Practice Address - Street 1:1800 ZOLLINGER RD FL 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2800
Practice Address - Country:US
Practice Address - Phone:614-293-4925
Practice Address - Fax:614-293-5503
Is Sole Proprietor?:No
Enumeration Date:2007-04-21
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35122660207RP1001X, 207RP1001X
MN52338207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0099702Medicaid
MNP01195939OtherRAILROAD MEDICARE
MN810000268Medicare PIN