Provider Demographics
NPI:1932441797
Name:PANCHANG, PREETI SAILESH (MD)
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:SAILESH
Last Name:PANCHANG
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: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:
Mailing Address - Fax:
Practice Address - Street 1:10305 HAMPTONS PARK DR
Practice Address - Street 2:STE 101
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6504
Practice Address - Country:US
Practice Address - Phone:704-895-9838
Practice Address - Fax:704-316-3083
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260746208100000X
NC2022-01264208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation