Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 35-046101 | OH |
NPI | 1508886573 |
---|---|
Provider Name | Pamela B Davis |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 20/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000028029 | ANTHEM (01) | OH |
000000221040 | UNISON (01) | OH |
0010525940003 | PA MEDICAID (01) | PA |
0496459 | (05) | OH |
0496459 | BCMH (01) | OH |
110062559 | RAILROAD MEDICARE (01) | OH |
363464 | WELLCARE (01) | OH |
639601 | AETNA (01) | OH |
745897 | BUCKEYE (01) | OH |
D31408 | (02) | OH |