Provider Demographics
NPI:1942278544
Name:PANESAR, GUNJAN (MD)
Entity Type:Individual
Prefix:
First Name:GUNJAN
Middle Name:
Last Name:PANESAR
Suffix:
Gender:F
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:BRIARWOOD PRIMARY CARE
Mailing Address - Street 2:445 CYPRESS STREET, SUITE 5
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103
Mailing Address - Country:US
Mailing Address - Phone:603-663-8200
Mailing Address - Fax:603-663-8209
Practice Address - Street 1:BRIARWOOD PRIMARY CARE
Practice Address - Street 2:445 CYPRESS STREET, SUITE 5
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-663-8200
Practice Address - Fax:603-663-8209
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015118207R00000X
NH13464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H08520Medicare UPIN