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General NPI Number Information
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NPI Number | 1033644737
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Entity Type | Individual
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Provider Name | NIKUL MAHENDRA PANCHAL
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Gender | Male
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 7730 W BOYNTON BEACH BLVD STE 7
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-6155
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Country | US
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Telephone | 561-258-9430
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Fax | 561-935-1582
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Provider Business Mailing Address
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Address Line | 7730 W BOYNTON BEACH BLVD STE 7
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-6155
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Country | US
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Telephone | 561-258-9430
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Fax | 561-935-1582
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00362900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | P04590
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License Number State | FL
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