Provider Demographics
NPI:1508820150
Name:STEINBERG, PAMELA H (PAC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:H
Last Name:STEINBERG
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20228 FARMINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152
Mailing Address - Country:US
Mailing Address - Phone:248-478-5221
Mailing Address - Fax:248-478-8425
Practice Address - Street 1:20228 FARMINGTON ROAD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152
Practice Address - Country:US
Practice Address - Phone:248-478-5221
Practice Address - Fax:248-478-8425
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601001819363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1508820150Medicaid
MI5821923P1Medicare PIN
R68669Medicare UPIN