MEDICARE: DR. NIMESH PANCHIGAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME91570	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346279148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIMESH PANCHIGAR M.D.

Provider Business Mailing Address
First Line	:	4543 S MANHATTAN AVE STE 103
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-2330
Country	:	US
Telephone Number	:	813-831-8888
Fax Number	:	813-831-6292

Provider Business Practice Location Address
First Line	:	4543 S MANHATTAN AVE STE 103
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-2330
Country	:	US
Telephone Number	:	813-831-8888
Fax Number	:	813-831-8888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	05/14/2010

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