Provider Demographics
NPI:1467424085
Name:DAVE, PRANAV (MD)
Entity Type:Individual
Prefix:DR
First Name:PRANAV
Middle Name:
Last Name:DAVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 E CAMPUS VIEW BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4647
Mailing Address - Country:US
Mailing Address - Phone:614-396-4733
Mailing Address - Fax:614-396-4742
Practice Address - Street 1:3525 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 5360
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3937
Practice Address - Country:US
Practice Address - Phone:614-340-7747
Practice Address - Fax:614-340-7742
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2024-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.0879212085R0202X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00318376OtherRR MEDICARE
OH4185231Medicare PIN
OHP00318376OtherRR MEDICARE