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Individual

AMIESHA S PANCHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
195 CANAL ST, MALDEN, MA 02148-6701
(781) 338-0500
Mailing address
195 CANAL ST, MALDEN, MA 02148-6701
(781) 338-0500

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
257728
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110098967A
MA
01
1568679843
NPI
MA
Enumeration date
05/17/2007
Last updated
02/27/2020
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