Provider Demographics
NPI:1295803708
Name:MYERS, PAMELA A (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:A
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26210 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7504
Mailing Address - Country:US
Mailing Address - Phone:276-623-8100
Mailing Address - Fax:276-623-8126
Practice Address - Street 1:26210 LEE HWY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7504
Practice Address - Country:US
Practice Address - Phone:276-623-8100
Practice Address - Fax:276-623-8126
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101059370208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
541777838OtherTAX ID
VA006730809Medicaid
VA284447OtherANTHEM
VA284447OtherANTHEM
VA284447OtherANTHEM