Provider Demographics
NPI:1528027158
Name:MCDEVITT, PAMELA KAY
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:KAY
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 COLONIAL WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-1922
Mailing Address - Country:US
Mailing Address - Phone:304-345-4188
Mailing Address - Fax:
Practice Address - Street 1:3100 MACCORKLE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1223
Practice Address - Country:US
Practice Address - Phone:304-388-8386
Practice Address - Fax:304-388-8323
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29851835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy