Eddie Pantzlaff, DDS is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Ann Arbor, Michigan. His current practice location is
1500 E. Medical Center Drive, G1200 Towsley Ctr, Rm 1211, Ann Arbor, Michigan. You can reach out to his office (for appointments etc.) via phone at
(734) 936-5950.
Eddie Pantzlaff is licensed to practice in Michigan (license number 2901022023) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1801248471.
Healthcare Provider's Profile
Full Name | Eddie Pantzlaff |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1500 E. Medical Center Drive, Ann Arbor, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1801248471
- Provider Enumeration Date: 07/07/2016
- Last Update Date: 05/11/2018
Medicare PECOS Information:
- PECOS PAC ID: 6002171261
- Enrollment ID: I20180517002883
Medical Identifiers
Medical identifiers for Eddie Pantzlaff such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1801248471 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 2901022023 (Michigan) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 2901022023 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Eddie Pantzlaff is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Eddie Pantzlaff, DDS 1500 E. Medical Center Drive, G1200 Towsley Ctr, Rm 1211, Ann Arbor, MI 48109-5222 Ph: (734) 936-5950 | Eddie Pantzlaff, DDS 1500 E. Medical Center Drive, G1200 Towsley Ctr, Rm 1211, Ann Arbor, MI 48109-5222 Ph: (734) 936-5950 |
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