Provider Demographics
NPI:1467495366
Name:WEINHOLD, PAMELA M (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:WEINHOLD
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:7405 RENNER RD
Practice Address - Street 2:KU MEDWEST
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-9414
Practice Address - Country:US
Practice Address - Phone:913-588-8400
Practice Address - Fax:913-588-8413
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-25577207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100423720BMedicaid
481159444OtherJAYHAWK TAX ID
31491019OtherBCBS
7501135OtherAETNA
506790OtherFIRSTGUARD
930121323OtherRR MEDICARE
10001313101OtherCHP PROVIDER NUMBER
157659XXOtherPREFERRED CARE OF NY
506790OtherFIRSTGUARD
KSJ61B883AMedicare PIN