Provider Demographics
NPI:1801887823
Name:PANTING, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PANTING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14156
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34280-4156
Mailing Address - Country:US
Mailing Address - Phone:941-739-0323
Mailing Address - Fax:941-739-5390
Practice Address - Street 1:401 2ND AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1105
Practice Address - Country:US
Practice Address - Phone:941-748-4600
Practice Address - Fax:941-748-4604
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 00707652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252067200Medicaid
FL31423OtherBCBS
FL3105413OtherGHI
FLV47660OtherAMERIHEALTH
FL5322733OtherCIGNA
FL200712OtherSTAYWELL HEALTHEASE WELLC
FL260038191OtherRAIL ROAD MEDICARE
FL5322733OtherCIGNA
FLV47660OtherAMERIHEALTH
FLV47660OtherAMERIHEALTH
FL200712OtherSTAYWELL HEALTHEASE WELLC