Provider Demographics
NPI:1639155476
Name:GUHA, PAMELA GALLAGHER (MD)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:GALLAGHER
Last Name:GUHA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2026 HERMITAGE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-2006
Mailing Address - Country:US
Mailing Address - Phone:301-261-0575
Mailing Address - Fax:
Practice Address - Street 1:9131 PISCATAWAY RD
Practice Address - Street 2:SUITE 750
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2508
Practice Address - Country:US
Practice Address - Phone:301-856-2810
Practice Address - Fax:301-856-7290
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0016116207RN0300X
DCMD6387207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B94597Medicare UPIN