Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Pranav Bollavaram

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629658133

Pranav Bollavaram is a Physical Medicine and Rehabilitation in Columbus, Ohio. Graduated from Northeastern Ohio University College of Medicine in 2021, 5 years ago. Practices as a sole proprietor.

Years since qualifying
5
Trained at
Northeastern Ohio University College of Medicine
In the registry since
2021
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Practice location Address checks out

395 W 12th Ave
Columbus, OH 43210-1267
Phone: (614) 685-4411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1629658133
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 9, 2021
Last updated in NPPESAugust 8, 2022
Certification dateAugust 8, 2022
Mailing address395 W 12th Ave, Columbus, OH 43210-1267

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolNORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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