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Individual

JOHN PANEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-6200
(505) 727-9590
Mailing address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-6200
(505) 727-9590

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
248
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
K2745
NM
Enumeration date
03/23/2006
Last updated
04/17/2017
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