Provider Demographics
NPI:1083713754
Name:PAJARO, NANCY E (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:E
Last Name:PAJARO
Suffix:
Gender:F
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:PO BOX 381807
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35238-1807
Mailing Address - Country:US
Mailing Address - Phone:205-661-9001
Mailing Address - Fax:256-464-9154
Practice Address - Street 1:3240 EDWARDS LAKE PKWY
Practice Address - Street 2:SUITE 208
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3117
Practice Address - Country:US
Practice Address - Phone:205-661-9001
Practice Address - Fax:256-464-9154
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051509843Medicare ID - Type Unspecified
ALF84059Medicare UPIN