MEDICARE: DR. PAMELA K ERDMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	028960	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447251459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA K ERDMAN MD

Provider Business Mailing Address
First Line	:	5364 OXBOW RD
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30087-1227
Country	:	US
Telephone Number	:	770-938-1757
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 NORTHLAKE PKWY
Second Line	:	STE 280
City	:	TUCKER
State	:	GA
Zip	:	30084-4022
Country	:	US
Telephone Number	:	770-938-1757
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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