Individual
DR. SAMIR BIPIN PANCHOLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 N STATE ST, CLARKS SUMMIT, PA 18411-1061
(570) 587-7817
(570) 587-7815
Mailing address
PO BOX 620, CHINCHILLA, PA 18410-0620
(570) 587-7817
(570) 587-7815
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD045919L
PA
207RI0011X
Interventional Cardiology Physician
Primary
MD045919L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001584853
—
PA
01
—
23711
GEISINGER HEALTH
PA
01
—
801519
FIRST PRIORITY HEALTH
PA
Enumeration date
01/24/2006
Last updated
07/21/2022
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