Provider Demographics
NPI:1508065293
Name:REYNOLDS, PAMELA P (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:P
Last Name:REYNOLDS
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 1:500 RAY C. HUNT DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:434-980-6140
Mailing Address - Fax:434-972-4266
Practice Address - Street 1:1222 JEFFERSON PARK AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0001
Practice Address - Country:US
Practice Address - Phone:434-924-1931
Practice Address - Fax:434-924-8410
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054133207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine