Basic Information
| Provider Information | |||||||||
| NPI: | 1497027726 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PANKAJ LAL, M.D., PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9307 RAPLEY PRESERVE DR | ||||||||
| Address2: | |||||||||
| City: | POTOMAC | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208545468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039946655 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9307 RAPLEY PRESERVE DR | ||||||||
| Address2: | |||||||||
| City: | POTOMAC | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208545468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039946655 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2012 | ||||||||
| LastUpdateDate: | 02/02/2012 | ||||||||
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| AuthorizedOfficialLastName: | LAL | ||||||||
| AuthorizedOfficialFirstName: | PANKAJ | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7039946655 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | D0039671 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.