Healthcare Provider Details

I. General information

NPI: 1427141712
Provider Name (Legal Business Name): SEEMA PANCHAL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2006
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 PLUM ORCHARD DR
SILVER SPRING MD
20904
US

IV. Provider business mailing address

12201 PLUM ORCHARD DR
SILVER SPRING MD
20904-7803
US

V. Phone/Fax

Practice location:
  • Phone: 201-600-0984
  • Fax:
Mailing address:
  • Phone: 201-863-3346
  • Fax: 301-572-1000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH84670
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: