Provider Demographics
NPI:1407294655
Name:PANTER, JOHN EDWARD (PA)
Entity Type:Individual
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First Name:JOHN
Middle Name:EDWARD
Last Name:PANTER
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Gender:M
Credentials:PA
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Mailing Address - Street 1:12127B HWY 14 N STE 5
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9557
Mailing Address - Country:US
Mailing Address - Phone:505-281-5180
Mailing Address - Fax:505-281-5320
Practice Address - Street 1:11501 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2796
Practice Address - Country:US
Practice Address - Phone:505-814-1333
Practice Address - Fax:505-990-3437
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2021-04-06
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant