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NPI Code Detail

MEDICARE: DR. GORAL PANCHAL M.D.

MEDICARE: DR. GORAL PANCHAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism PhysicianMD483391PA
2390200000XStudent in an Organized Health Care Education/Training Program
3207RE0101XEndocrinology, Diabetes & Metabolism Physician4301111314MI

General Provider Information

NPI Number : 1245528884
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GORAL PANCHAL M.D.
Provider Business Mailing Address
First Line : 4000 WELLNESS DR
Second Line :
City : MIDLAND
State : MI
Zip : 48670-2000
Country : US
Telephone Number : 989-839-3000
Fax Number :
Provider Business Practice Location Address
First Line : 4851 E PICKARD ST STE 2400
Second Line :
City : MT PLEASANT
State : MI
Zip : 48858-2042
Country : US
Telephone Number : 989-956-9128
Fax Number : 989-956-9157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2011
Last Update Date : 11/27/2024

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