Individual
PANKAJ P DANGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3536 VISTA AVE, SAINT LOUIS, MO 63104-1006
(314) 577-8317
(314) 268-5466
Mailing address
500 22ND ST S, APARTMENT -A, BIRMINGHAM, AL 35233-3110
(314) 932-5179
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01086725A
IN
2088P0231X
Pediatric Urology Physician
01086725A
IN
2088P0231X
Pediatric Urology Physician
Primary
35045
AL
390200000X
Student in an Organized Health Care Education/Training Program
2009017783
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001615180
ANTHEM PTAN
IN
05
—
300056424
—
IN
Enumeration date
07/08/2009
Last updated
03/06/2025
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