Basic Information
| Provider Information | |||||||||
| NPI: | 1518159136 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PANWAR | ||||||||
| FirstName: | ARU | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MBBS, M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 825 S 169TH ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681189300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023543370 | ||||||||
| FaxNumber: | 4023545454 | ||||||||
| Practice Location | |||||||||
| Address1: | 8303 DODGE ST STE 304 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681144108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023545048 | ||||||||
| FaxNumber: | 4023542585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2007 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YX0007X | 27036 | NE | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Plastic Surgery within the Head & Neck |
ID Information
| ID | Type | State | Issuer | Description | 27036 | 01 | NE | NE STATE LICENSE | OTHER | 1518159136 | 05 | IA | MEDICAID | 10025044400 | 05 | NE | MEDICAID |