Provider Demographics
NPI:1336144930
Name:DAVIS, PAMELA D (DO)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1601 N HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:MO
Mailing Address - Zip Code:64080-1945
Mailing Address - Country:US
Mailing Address - Phone:816-540-2111
Mailing Address - Fax:816-540-6065
Practice Address - Street 1:1601 N HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:MO
Practice Address - Zip Code:64080-1945
Practice Address - Country:US
Practice Address - Phone:816-540-2111
Practice Address - Fax:816-540-6065
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2001002804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
28581041OtherBCBS
706A949OtherMEDICARE INDIVIDUAL
706A949OtherMEDICARE INDIVIDUAL
MO263485Medicare Oscar/Certification