Provider Demographics
NPI:1508800095
Name:PANAS, GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:PANAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24164 KINNARDS POINT DR
Mailing Address - Street 2:
Mailing Address - City:WORTON
Mailing Address - State:MD
Mailing Address - Zip Code:21678-1315
Mailing Address - Country:US
Mailing Address - Phone:410-810-3949
Mailing Address - Fax:
Practice Address - Street 1:100 BROWN ST
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1435
Practice Address - Country:US
Practice Address - Phone:410-778-1311
Practice Address - Fax:410-778-0623
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD53250174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD38066OtherPRIORITY PARTNERS
MD558450OtherMAMSI/MD IPA/OPT. CHOICE
MDW1610002OtherBC/BS FEDERAL
MD112941OtherCOVENTRY
MDLU86CHOtherCAREFIRST BC/BS
MDW1610002OtherCAREFIRST BLUECHOICE
MD423043OtherBCBS POINT OF SERVICE
MD38066OtherPRIORITY PARTNERS
MDLU86CHOtherCAREFIRST BC/BS