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NPI Code Detail

MEDICARE: DR. EFRAIM PANGANIBAN DAVID MD

MEDICARE: DR. EFRAIM PANGANIBAN DAVID MD
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
12084N0400XNeurology Physician36107115IL

General Provider Information

NPI Number : 1730120411
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EFRAIM PANGANIBAN DAVID MD
Provider Business Mailing Address
First Line : 1970 ROANOKE BLVD
Second Line : 1A-1006
City : SALEM
State : VA
Zip : 24153-6404
Country : US
Telephone Number : 540-982-2463
Fax Number : 540-855-3414
Provider Business Practice Location Address
First Line : 1970 ROANOKE BLVD
Second Line : 1A-1006
City : SALEM
State : VA
Zip : 24153-6404
Country : US
Telephone Number : 540-982-2463
Fax Number : 540-855-3414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 07/08/2007

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