Provider Demographics
NPI:1952339368
Name:IVEY, PAMELA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:A
Last Name:IVEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:2865 SIENA HEIGHTS DR STE 331
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4171
Practice Address - Country:US
Practice Address - Phone:702-407-0110
Practice Address - Fax:702-407-0133
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-10-25
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Provider Licenses
StateLicense IDTaxonomies
NV9400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1952339368Medicaid
NVGE620Z (CQ328A)Medicare PIN
NV1952339368Medicaid