Provider Demographics
NPI:1710320981
Name:MARQUESS, PAMALA SMITH (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAMALA
Middle Name:SMITH
Last Name:MARQUESS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 ROSWELL RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-3670
Mailing Address - Country:US
Mailing Address - Phone:770-973-7600
Mailing Address - Fax:770-973-3032
Practice Address - Street 1:1480 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-3670
Practice Address - Country:US
Practice Address - Phone:770-973-7600
Practice Address - Fax:770-973-3032
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0176651835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist