Individual
DR. LUIZ C PANTALENA FILHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
4322 S LAFAYETTE BLVD, SOUTH BEND, IN 46614-2518
(574) 391-1111
(574) 859-5040
Mailing address
4322 S LAFAYETTE BLVD, SOUTH BEND, IN 46614-2518
(574) 391-1111
(574) 859-5040
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01073773A
IN
207ND0101X
MOHS-Micrographic Surgery Physician
01073773A
IN
Other
Enumeration date
05/17/2011
Last updated
04/11/2025
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