Provider Demographics
NPI:1578648846
Name:MEYER, PAMELA L (DO)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:L
Last Name:MEYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 KICHLINE AVE
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-1010
Mailing Address - Country:US
Mailing Address - Phone:484-851-3000
Mailing Address - Fax:484-851-3064
Practice Address - Street 1:32 KICHLINE AVE
Practice Address - Street 2:
Practice Address - City:HELLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18055-1010
Practice Address - Country:US
Practice Address - Phone:484-851-3000
Practice Address - Fax:484-851-3064
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA05008600L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG17799Medicare UPIN
PA132084Medicare PIN