Provider Demographics
NPI:1326037854
Name:PANICO, FREDERICK GENNARO (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:GENNARO
Last Name:PANICO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1551 1ST ST S
Mailing Address - Street 2:#301
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-6360
Mailing Address - Country:US
Mailing Address - Phone:904-247-8556
Mailing Address - Fax:904-249-2739
Practice Address - Street 1:NANTICOKE MEMORIAL HOSPITAL,
Practice Address - Street 2:801 MIDDLEFORD RD
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973
Practice Address - Country:US
Practice Address - Phone:302-629-6611
Practice Address - Fax:302-629-0863
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2022-12-05
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Provider Licenses
StateLicense IDTaxonomies
NC2020-03411207L00000X
DEC1-0006196207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG40652Medicare UPIN