Provider Demographics
NPI:1346449337
Name:PANCHOLY, BHARAT (MD)
Entity Type:Individual
Prefix:DR
First Name:BHARAT
Middle Name:
Last Name:PANCHOLY
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:(112)
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-972-2000
Mailing Address - Fax:813-910-4036
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD # 112
Practice Address - Street 2:JAMES A HALEY TAMPA VA
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:813-910-4036
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA104641208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery