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Individual

DR. RONALD J PANCNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2805 FAIRFIELD AVE, FORT WAYNE, IN 46807-1218
(260) 456-4880
(260) 456-3559
Mailing address
2805 FAIRFIELD AVE, FORT WAYNE, IN 46807-1218
(260) 456-4880
(260) 456-3559

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01019854
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100463070
IN
Enumeration date
06/14/2006
Last updated
10/20/2022
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