Provider Demographics
NPI:1417095811
Name:TRAUM, PAMELA M (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:M
Last Name:TRAUM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7503
Mailing Address - Country:US
Mailing Address - Phone:480-456-3703
Mailing Address - Fax:480-456-0477
Practice Address - Street 1:2135 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7503
Practice Address - Country:US
Practice Address - Phone:480-456-3703
Practice Address - Fax:480-456-0477
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5821111N00000X
AZ3442111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ60211Medicare ID - Type UnspecifiedMEDICARE NUMBER
AZU77991Medicare UPIN