Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 0101227541 | VA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 0101227541 | VA |
NPI | 1154310605 |
---|---|
Provider Name | Pamela K. Mason |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903-2981 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I12337 | (02) | VA |