Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL JUDE PANKAU, MD
ActivePediatrics · IDAHO FALLS, ID
Registration Details
- NPI Number
- 1558475111
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 19, 2006 (19.689947077998 yrs)
- Last Updated
- Sep 10, 2009
- Licenses
-
M4815 (ID)F9918 (TX)
Practice Information
- Address
-
3430 WASHINGTON PKWYIDAHO FALLS, ID, 834047579Browse ID providers · Browse ZIP 83404
- Phone
- 2085233060
- Fax
- 2085230028
- Primary Specialty
-
Pediatrics
208000000X
- Additional Specialty
- Pediatrics
Other Pediatrics Providers in IDAHO FALLS, ID
| Name | Credential | NPI |
|---|---|---|
| JILL DENISE VEBER | MD | 1235243973 |
| BRADFORD NELSON HATCH | MD | 1265546915 |
| DIANE RAE NIELSEN | PA C | 1205940962 |
| BRAD REID EDWARDS | DO | 1093829657 |
| ROBERT JOHN PETTIT | MD | 1518071174 |
| ERIC PETER OLSON | MD | 1053425611 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.