Provider Demographics
NPI:1104894708
Name:PANESAR, MAHENDRA SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:MAHENDRA
Middle Name:SINGH
Last Name:PANESAR
Suffix:
Gender:M
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:PEDIATRIC HEALTH ASSOCIATES
Mailing Address - Street 2:275 MAMMOTH ROAD, SUITE 1
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109
Mailing Address - Country:US
Mailing Address - Phone:603-663-8350
Mailing Address - Fax:603-663-8399
Practice Address - Street 1:PEDIATRIC HEALTH ASSOCIATES
Practice Address - Street 2:275 MAMMOTH ROAD, SUITE 1
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109
Practice Address - Country:US
Practice Address - Phone:603-663-8350
Practice Address - Fax:603-663-8399
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013589208000000X
NH13509208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH13509OtherNH LICENSE