Individual
TERENCE PANVICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
913 E 26TH ST, 600, MINNEAPOLIS, MN 55404-4515
(612) 775-6200
(612) 775-6222
Mailing address
913 E 26TH ST, 600, MINNEAPOLIS, MN 55404-4515
(612) 775-6200
(612) 775-6222
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9325
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157893600
—
MN
Enumeration date
06/21/2006
Last updated
11/10/2020
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