Individual
PANCHADCHARAM GNANESWARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
204 SOUTH ST, ELKTON, MD 21921-5633
(410) 392-8000
(410) 392-5990
Mailing address
P O BOX 3012, WILMINGTON, DE 19804
(302) 224-5678
(302) 224-2848
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M37596
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52827004
MD BLUE CROSS
MD
Enumeration date
11/13/2006
Last updated
07/08/2007
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