Provider Demographics
NPI:1033170816
Name:MILLER, PAMELA
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NORTH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4147
Mailing Address - Country:US
Mailing Address - Phone:413-499-8510
Mailing Address - Fax:
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37610207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043531502OtherNORTH AMERICAN HEALTH
MA043531502OtherUHC
MA10034398OtherCDPHP
MA3871953OtherCIGNA/HEALTHSOURCE
MAB96370OtherHARVARD
MA000000020932OtherHEALTHNET
MA043531502OtherCIGNA INDEMNITY
MA043531502OtherGIC INDEMNITY
MA043531502OtherHMC PPO
MA2046504Medicaid
MAI22231OtherBCBS
MA037610OtherTUFTS
MA110531OtherMVP
MA0016668OtherNEIGHBORHOOD HEALTH
MA110213741OtherRAILROAD MEDICARE
MA14480OtherHEALTH NEW ENGLAND
MA110531OtherMVP
MAI22231Medicare ID - Type Unspecified