Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01060164A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 39505 | KY |
Y | 207RI0011X | Interventional Cardiology | 01060164A | IN |
N | 207RI0011X | Interventional Cardiology | 39505 | KY |
NPI | 1073561254 |
---|---|
Provider Name | Dr. Frank X Pamelia |
First Address | Newburgh, IN 47630-8925 |
Second Address | Newburgh, IN 47630-8947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000365348 | ANTHEM (01) | |
200307640 | (05) | IN |
64101843 | (05) | KY |
A80301 | (02) | |
P00240338 | RR MCR (01) | IN |
P00351736 | RR MCR (01) | KY |