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General NPI Number Information
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NPI Number | 1598224925
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Entity Type | Individual
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Provider Name | TOMAS PANEQUE MD
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Gender | Male
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 229 CLEARFIELD AVE STE 300
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1946
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Country | US
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Telephone | 757-457-5100
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Fax | 757-961-3696
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Provider Business Mailing Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-2421
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Fax | 319-356-3900
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101285472
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License Number State | VA
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