Provider Demographics
NPI:1639136633
Name:PANNI, SAADAT A (MD)
Entity Type:Individual
Prefix:
First Name:SAADAT
Middle Name:A
Last Name:PANNI
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 1:217 PHILLIP MORRIS DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1923
Mailing Address - Country:US
Mailing Address - Phone:410-546-3173
Mailing Address - Fax:410-742-4804
Practice Address - Street 1:217 PHILLIP MORRIS DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1923
Practice Address - Country:US
Practice Address - Phone:410-546-3173
Practice Address - Fax:410-742-4804
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052918208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics