Provider Demographics
NPI:1740222413
Name:MEHALICK, PAMELA G (DO)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:G
Last Name:MEHALICK
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:BALDWIN TOWER
Practice Address - Street 2:1510 CHESTER PIKE, SUITE 105
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1375
Practice Address - Country:US
Practice Address - Phone:484-485-2005
Practice Address - Fax:484-485-2009
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2016-01-15
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Provider Licenses
StateLicense IDTaxonomies
PAOS0048256L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
077356 SK3Medicare PIN