Provider Demographics
NPI:1730137282
Name:OJHA, PAMELA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LYNN
Last Name:OJHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:LYNN
Other - Last Name:ALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:634 LOGGERHEAD ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3849
Mailing Address - Country:US
Mailing Address - Phone:321-506-3985
Mailing Address - Fax:
Practice Address - Street 1:1326 MALABAR RD SE STE 3
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2502
Practice Address - Country:US
Practice Address - Phone:321-409-6100
Practice Address - Fax:321-409-6100
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2017-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83169207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05080OtherBCBS
FLP00382940OtherRR MEDICARE
FL263030300Medicaid
FL05080OtherBCBS OF FLORIDA
FL263030300Medicaid
H51853Medicare UPIN
FL05080YMedicare PIN