Individual
DR. DAVID PANTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1593
Mailing address
55 WEST TIETAN, WALLA WALLA, WA 99362
(509) 525-3720
(509) 522-1593
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A130849
CA
207N00000X
Dermatology Physician
Primary
MD60726633
WA
207ND0101X
MOHS-Micrographic Surgery Physician
MD457554
PA
207ND0101X
MOHS-Micrographic Surgery Physician
MD60726633
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2078121
—
WA
Enumeration date
05/22/2012
Last updated
07/21/2022
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