Provider Demographics
NPI:1740506450
Name:PANCHAL, AMAR MAHENDRAKANT (MD)
Entity type:Individual
Prefix:DR
First Name:AMAR
Middle Name:MAHENDRAKANT
Last Name:PANCHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AMAR
Other - Middle Name:MAHENDRA
Other - Last Name:PANCHAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-9900
Mailing Address - Fax:704-384-9919
Practice Address - Street 1:1918 RANDOLPH RD
Practice Address - Street 2:STE 580
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1116
Practice Address - Country:US
Practice Address - Phone:704-384-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10036604207RC0200X
PAMT190169207R00000X
NC2015-01274207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease