Provider Demographics
NPI:1962490599
Name:RO, PAMELA SUE (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:RO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANNING DRIVE MG 140
Mailing Address - Street 2:CB 7232
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:984-974-4601
Mailing Address - Fax:984-974-7385
Practice Address - Street 1:101 MANNING DRIVE MG 140
Practice Address - Street 2:CB 7232
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:984-974-4601
Practice Address - Fax:984-974-7385
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350801412080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2277405Medicaid
WV3004078000Medicaid
KY64043516Medicaid
KY64043516Medicaid
WV3004078000Medicaid