Individual
DR. BRIAN PANFALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNAP, CRNA
Contact information
Practice address
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043-2920
(586) 493-8000
Mailing address
20360 RAMBLING DR, CLINTON TOWNSHIP, MI 48038-7507
(586) 625-2757
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704314956
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704314956
MI
Other
Enumeration date
07/27/2022
Last updated
08/30/2022
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