Provider Demographics
NPI:1396766564
Name:PANJIKARAN, GEORGE C (MD)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:C
Last Name:PANJIKARAN
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 1:603 E OLYMPIA AVE
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3839
Mailing Address - Country:US
Mailing Address - Phone:941-639-7070
Mailing Address - Fax:941-639-2458
Practice Address - Street 1:603 E OLYMPIA AVE
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3839
Practice Address - Country:US
Practice Address - Phone:941-639-7070
Practice Address - Fax:941-639-2458
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34716207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08094OtherBCBS FLORIDA
D51977Medicare UPIN
FL08094OtherBCBS FLORIDA