Provider Demographics
NPI:1831142686
Name:CAVA, PAMELA S (DO)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:CAVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:SAYGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9555 76TH ST
Mailing Address - Street 2:SUITE 4106
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1984
Mailing Address - Country:US
Mailing Address - Phone:262-653-5437
Mailing Address - Fax:262-577-8715
Practice Address - Street 1:9555 76TH ST
Practice Address - Street 2:SUITE 4106
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1984
Practice Address - Country:US
Practice Address - Phone:262-653-5437
Practice Address - Fax:262-577-8715
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0952852080P0202X
WI433402080P0202X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1831142686Medicaid
IL43492700Medicaid
ILH39238Medicare UPIN
IL43492700Medicaid
IL73601Medicare ID - Type Unspecified
WI0062 73-601Medicare PIN