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General NPI Number Information
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NPI Number | 1245475367
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Entity Type | Organization
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Legal Business Name | NU WAVE MEDICAL CENTER PA
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 12007 PANAMA CITY BEACH PARKWAY
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2607
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Country | US
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Telephone | 850-249-6363
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Fax | 850-249-6675
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Provider Business Mailing Address
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Address Line | P.O. BOX 9415
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-3823
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Country | US
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Telephone | 850-249-6363
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Fax | 850-249-6675
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Authorized Official
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Title or Position | MD
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Name | DR. GURPRIT SEKHON
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Credential | MD
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Telephone | 850-249-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME83912
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License Number State | FL
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