Provider Demographics
NPI:1689868671
Name:PANAMERICAN INTERNAL MEDICINE, P.C.
Entity Type:Organization
Organization Name:PANAMERICAN INTERNAL MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-532-5044
Mailing Address - Street 1:6201 LEESBURG PIKE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2201
Mailing Address - Country:US
Mailing Address - Phone:703-532-5044
Mailing Address - Fax:703-532-5944
Practice Address - Street 1:6201 LEESBURG PIKE
Practice Address - Street 2:SUITE 410
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2201
Practice Address - Country:US
Practice Address - Phone:703-532-5044
Practice Address - Fax:703-532-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-01
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA149925Medicare PIN