Phillips, Pamela Martin

Phillips, Pamela Martin is an individual health care provider with primary practice located at 1120 Kanawha Blvd E , Charleston WV 25301-2400. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Phillips, Pamela Martin can be contacted via phone (304) 344-3457.

Contact Information

Primary practice address
1120 Kanawha Blvd E Charleston WV 25301-2400
Phone: (304) 344-3457
Fax: (304) 344-3480
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X 19277 West Virginia
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 19277 West Virginia

Profile Details

NPI number 1992760698
LBN Legal business name Phillips, Pamela Martin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Aug 4th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992760698 NPPES
Virginia MEDICAID 7243898
Virginia MEDICAID 7243871
Virginia MEDICAID 7243880
Virginia MEDICAID 7243863
Virginia MEDICAID 0122386000
Virginia Other 6688-0024
Virginia MEDICAID 7247371

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