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General NPI Number Information
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NPI Number | 1811993249
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Entity Type | Organization
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Legal Business Name | PAHNKE, PENMAN, AND WHITNEY PA
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 03/21/2014
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Provider Practice Location Address
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Address Line | 410 FOULK RD STE 200A
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City | WILMINGTON
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State | DE
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Zip | 19803-3802
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Country | US
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Telephone | 302-764-2380
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Fax | 302-764-3501
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Provider Business Mailing Address
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Address Line | 4701 OGLETOWN STANTON RD SUITE 1340
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City | NEWARK
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State | DE
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Zip | 19713-2055
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Country | US
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Telephone | 302-733-0404
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Fax | 302-733-0556
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREG RANDOLPH PAHNKE
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Credential | M.D.
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Telephone | 302-733-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C10002136
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License Number State | DE
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