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General NPI Number Information
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NPI Number | 1437112810
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Entity Type | Individual
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Provider Name | SUNIL J PANCHAL MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 4911 VAN DYKE ROAD
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City | LUTZ
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State | FL
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Zip | 33558-4813
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Country | US
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Telephone | 813-264-7246
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Fax | 813-264-7249
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Provider Business Mailing Address
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Address Line | 4911 VAN DYKE ROAD
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City | LUTZ
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State | FL
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Zip | 33558-4813
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Country | US
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Telephone | 813-264-7246
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Fax | 813-264-7249
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME93346
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME93346
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License Number State | FL
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