Healthcare Provider Details

I. General information

NPI: 1700226495
Provider Name (Legal Business Name): SARJU PANCHAL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

3400 CIVIC CENTER BLVD SOUTH PAVILION 7TH FLOOR
PHILADELPHIA PA
19104-6160
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-4000
  • Fax:
Mailing address:
  • Phone: 703-996-6136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD475187
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: