Pankau, Michael Jude

Pankau, Michael Jude is an individual health care provider with primary practice located at 3430 Washington Pkwy , Idaho Falls ID 83404-7579. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Pankau, Michael Jude can be contacted via phone (208) 523-3060.

Contact Information

Primary practice address
3430 Washington Pkwy Idaho Falls ID 83404-7579
Phone: (208) 523-3060
Fax: (208) 523-0028
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M4815 Idaho
Allopathic & Osteopathic Physicians / Pediatrics 208000000X F9918 Texas

Profile Details

NPI number 1558475111
LBN Legal business name Pankau, Michael Jude
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Sep 10th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558475111 NPPES
Idaho MEDICAID 0038900000
Idaho MEDICAID 110702000
Idaho Other 000010005951
Idaho MEDICAID 0117402
Idaho MEDICAID 1285786046
Idaho Other 48157

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