Provider Demographics
NPI:1265528343
Name:SANWAL, PANKAJ (MD)
Entity type:Individual
Prefix:DR
First Name:PANKAJ
Middle Name:
Last Name:SANWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21141 STERLING AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-5571
Mailing Address - Country:US
Mailing Address - Phone:302-856-6967
Mailing Address - Fax:302-855-0744
Practice Address - Street 1:21141 STERLING AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-5563
Practice Address - Country:US
Practice Address - Phone:302-856-3969
Practice Address - Fax:302-856-3140
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10005413208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000041255Medicaid
DE0000904101Medicaid
DE1000041255Medicaid