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Individual

DR. JACOB A PANICI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
103 PARKWAY OFFICE CT STE 100, CARY, NC 27518-7429
(919) 481-3338
Mailing address
1514 GLENWOOD AVE, GLENWOOD AVENUE FOOT AND ANKLE, PLLC, RALEIGH, NC 27608-2368
(919) 829-0076
(919) 836-9094

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
635
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
635
NC
213ES0131X
Foot Surgery Podiatrist
635
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4861725
AETNA
NC
Enumeration date
07/19/2013
Last updated
08/22/2019
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