Provider Demographics
NPI:1952300709
Name:STETZER, PAMELA A (DO)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:STETZER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:A
Other - Last Name:KVIRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:454 OLD STREET RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1200
Mailing Address - Country:US
Mailing Address - Phone:603-924-9444
Mailing Address - Fax:603-924-8709
Practice Address - Street 1:454 OLD STREET RD
Practice Address - Street 2:SUITE 302
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1200
Practice Address - Country:US
Practice Address - Phone:603-924-9444
Practice Address - Fax:603-924-8709
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007921207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30226436Medicaid
OH000000387130OtherANTHEM
OH2377897Medicaid
OH2377897Medicaid
OH000000387130OtherANTHEM
OH4098662Medicare PIN