Provider Demographics
NPI:1104010792
Name:D'SOUZA-DAVID, PAMELA (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:D'SOUZA-DAVID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:PRITISAGAR
Other - Last Name:D'SOUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8101 SANDY SPRING RD STE 108
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3596
Mailing Address - Country:US
Mailing Address - Phone:240-917-2770
Mailing Address - Fax:240-360-4642
Practice Address - Street 1:8101 SANDY SPRING RD STE 108
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3596
Practice Address - Country:US
Practice Address - Phone:240-917-2770
Practice Address - Fax:240-360-4642
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD72803207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC436278YHW6OtherMEDICARE NPI
MD228667YAPWOtherMEDICARE NPI