Basic Information
| Provider Information | |||||||||
| NPI: | 1063539666 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PANICARI | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1530 E. 6TH STREET | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753225757 | ||||||||
| FaxNumber: | 7753225776 | ||||||||
| Practice Location | |||||||||
| Address1: | 1530 E. 6TH STREET | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753225757 | ||||||||
| FaxNumber: | 7753225776 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 05/13/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083X0100X | 3909 | NV | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.