Provider Demographics
NPI:1932178688
Name:PANCHAL, ROHIT (MD)
Entity type:Individual
Prefix:DR
First Name:ROHIT
Middle Name:
Last Name:PANCHAL
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 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-422-1372
Mailing Address - Fax:
Practice Address - Street 1:900 TOWNE LAKE PKWY STE 206
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1603
Practice Address - Country:US
Practice Address - Phone:770-852-7740
Practice Address - Fax:770-852-7741
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069918207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05573307Medicaid
MSP00423212OtherMEDICARE RAILROAD
290000138Medicare PIN