Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0101245709 | VA |
N | 207Q00000X | Family Doctor | 01064480A | IN |
NPI | 1003846833 |
---|---|
Provider Name | Dr. Pamela Mcghee Somervell |
First Address | Saltville, VA 24370-0729 |
Second Address | Saltville, VA 24370-3112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 24/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101245709 | PHYSICIAN LICENSE (01) | VA |
01064480A | PHYSICIAN LICENSE # (01) | IN |