Provider Demographics
NPI:1538541719
Name:PANSARI, MRIDUL (MD)
Entity type:Individual
Prefix:
First Name:MRIDUL
Middle Name:
Last Name:PANSARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:302-674-0600
Mailing Address - Fax:302-672-7144
Practice Address - Street 1:200 BANNING ST STE 200
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3487
Practice Address - Country:US
Practice Address - Phone:302-674-0600
Practice Address - Fax:302-672-7144
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0024889208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery