Provider Demographics
NPI:1982750113
Name:PAMER, MICHAEL GEORGE (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
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 1:1165 N HAMILTON RD
Mailing Address - Street 2:SUITE 01250
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3452
Mailing Address - Country:US
Mailing Address - Phone:614-337-1178
Mailing Address - Fax:614-337-1423
Practice Address - Street 1:1165 N HAMILTON RD
Practice Address - Street 2:SUITE 01250
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3452
Practice Address - Country:US
Practice Address - Phone:614-337-1178
Practice Address - Fax:614-337-1423
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4232421OtherMEDICARE GROUP PTAN