Provider Demographics
NPI:1073561254
Name:PAMELIA, FRANK X (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:X
Last Name:PAMELIA
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 1:4015 GATEWAY BLVD STE 2120
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8925
Mailing Address - Country:US
Mailing Address - Phone:812-842-0907
Mailing Address - Fax:812-464-4485
Practice Address - Street 1:4007 GATEWAY BLVD
Practice Address - Street 2:STE100
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8947
Practice Address - Country:US
Practice Address - Phone:812-842-0907
Practice Address - Fax:812-490-5536
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060164A207RC0000X, 207RI0011X
KY39505207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00351736OtherRR MCR
IN200307640Medicaid
KY64101843Medicaid
000000365348OtherANTHEM
INP00240338OtherRR MCR
IN532500DDDMedicare PIN
000000365348OtherANTHEM
KY0255545Medicare PIN