Provider Demographics
NPI:1457407769
Name:PAMER, MATHIAS GEORGE (DC)
Entity type:Individual
Prefix:
First Name:MATHIAS
Middle Name:GEORGE
Last Name:PAMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S LEXINGTON SPRINGMILL RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1330
Mailing Address - Country:US
Mailing Address - Phone:419-529-2703
Mailing Address - Fax:419-529-3984
Practice Address - Street 1:300 S LEXINGTON SPRINGMILL RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-1330
Practice Address - Country:US
Practice Address - Phone:419-529-2703
Practice Address - Fax:419-529-3984
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2160521Medicaid
OHPA4049151Medicare ID - Type Unspecified
OH2160521Medicaid