Individual
GARY M PANIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7096 DECATUR ST, NEW TRIPOLI, PA 18066-3815
(610) 298-8521
(610) 298-3021
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS006044E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010797850002
—
PA
Enumeration date
09/26/2005
Last updated
02/10/2022
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