Provider Demographics
NPI:1184771099
Name:NG, PAMELA (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:NG
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 1:5001 ROCKSIDE RD
Mailing Address - Street 2:DERMATOLOGY IN40
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2172
Mailing Address - Country:US
Mailing Address - Phone:216-986-4140
Mailing Address - Fax:216-986-4923
Practice Address - Street 1:5001 ROCKSIDE RD
Practice Address - Street 2:DERMATOLOGY IN40
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2172
Practice Address - Country:US
Practice Address - Phone:216-986-4140
Practice Address - Fax:216-986-4923
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH84288207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology