Individual
DR. SIDHARTH PANCHAMIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3140 S FALKENBURG RD STE 205, RIVERVIEW, FL 33578-2594
(813) 533-5522
(813) 533-5511
Mailing address
3140 S FALKENBURG RD STE 205, RIVERVIEW, FL 33578-2594
(813) 533-5522
(813) 533-5511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME 106682
FL
208VP0000X
Pain Medicine Physician
ME106682
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
ME106682
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01279725
RR MEDICARE
FL
Enumeration date
06/01/2007
Last updated
08/19/2024
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