Provider Demographics
NPI:1013909373
Name:PANCHOOSINGH, HARDEO KARAMCHAND (MD)
Entity Type:Individual
Prefix:DR
First Name:HARDEO
Middle Name:KARAMCHAND
Last Name:PANCHOOSINGH
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 1:3840 N DESERT OASIS CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-6926
Mailing Address - Country:US
Mailing Address - Phone:813-545-1703
Mailing Address - Fax:
Practice Address - Street 1:33 WHITING HILL RD
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1021
Practice Address - Country:US
Practice Address - Phone:207-973-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME816272080P0207X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002561100Medicaid
AZ631764Medicaid
AZ68650Medicare ID - Type UnspecifiedINDIVIDUAL
FL002561100Medicaid
FLEF132ZMedicare PIN