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NPI Code Detail

MEDICARE: PAMELA S POTASH D. O.

MEDICARE: PAMELA S POTASH D. O.
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
1207Q00000XFamily Medicine Physician0S009893LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00262035OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17053141OTHERAETNA
27053141OTHERUSH/HMO
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
650051245OTHERCAPITAL BLUE
7P002389OTHERGATEWAY
8624163OTHERBLUE SHIELD

General Provider Information

NPI Number : 1659483139
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA S POTASH D. O.
Provider Business Mailing Address
First Line : 1251 E MAIN ST
Second Line :
City : ANNVILLE
State : PA
Zip : 17003-1643
Country : US
Telephone Number : 717-867-4671
Fax Number : 717-867-4981
Provider Business Practice Location Address
First Line : 1251 E MAIN ST
Second Line :
City : ANNVILLE
State : PA
Zip : 17003-1643
Country : US
Telephone Number : 717-867-4671
Fax Number : 717-867-4981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 03/16/2021

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Practice Location Address:
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1770587396 — ROBERT K NIELSEN M.D.
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1457356826 — DR. DAVID M ENGLE M.D.
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Practice Fax: 717-867-4981
1871645291 — JENNIFER L KESTERSON CRNP
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1952438384 — ELIZABETH V SEIVERLING M.D.
Practice Location Address:
1251 E MAIN ST
ANNVILLE, PA
17003-1643
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Practice Fax:
1497967665 — ANAY DILIP PRADHAN MD
Practice Location Address:
1251 E MAIN ST , SUITE 3
ANNVILLE, PA
17003-1643
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Practice Fax: 717-731-8359

Directions to “ PAMELA S POTASH D. O.” Practice Location

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