Provider Demographics
NPI:1952356875
Name:CONNORS, PAMELA J (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:CONNORS
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 1:80 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2718
Mailing Address - Country:US
Mailing Address - Phone:401-348-7010
Mailing Address - Fax:401-348-7020
Practice Address - Street 1:80 BEACH STREET
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891
Practice Address - Country:US
Practice Address - Phone:401-348-7010
Practice Address - Fax:401-348-7020
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09057207RG0100X
CT034199207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT003096931Medicaid
RIPC24811Medicaid
CT003096931Medicaid
E70888Medicare UPIN
RI007009105Medicare ID - Type Unspecified