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Individual
THOMAS PRANIKOFF
Active
Individual
THOMAS PRANIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
9701110
NC
2086S0120X
Pediatric Surgery Physician
9701110
NC
2086S0129X
Vascular Surgery Physician
9701110
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1066M
BCBS
—
01
—
17510
PARTNERS
—
05
—
2005048000
—
WV
01
—
20051992
RR MEDICARE
—
01
—
5510597
AETNA
—
05
—
6724507
—
VA
01
—
74141
MEDCOST
—
05
—
891066M
—
NC
05
—
Q01110
—
SC
Enumeration date
12/16/2005
Last updated
11/12/2010
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