Healthcare Provider Details

I. General information

NPI: 1285880799
Provider Name (Legal Business Name): AMIT PANT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6908 PROVIDENCE PARK DR S
MOBILE AL
36695
US

IV. Provider business mailing address

PO BOX 18981
BELFAST ME
04915-4084
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-3490
  • Fax: 251-660-3491
Mailing address:
  • Phone: 251-342-3949
  • Fax: 251-266-3361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number31122
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: