Provider Demographics
NPI:1346375391
Name:PAMINTUAN, ELVIRA LACDAO (MD)
Entity Type:Individual
Prefix:DR
First Name:ELVIRA
Middle Name:LACDAO
Last Name:PAMINTUAN
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 1:1400 MIDDLEFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973
Mailing Address - Country:US
Mailing Address - Phone:302-629-6705
Mailing Address - Fax:302-629-6705
Practice Address - Street 1:1400 MIDDLEFORD ROAD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973
Practice Address - Country:US
Practice Address - Phone:302-629-6705
Practice Address - Fax:302-629-6705
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10002021207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000158901Medicaid
B66567Medicare UPIN
179307Medicare ID - Type Unspecified