MEDICARE: MRS. PAMELA F HAGAMAN PT,OCS

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	225100000X	Physical Therapist	5033	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07832	OTHER	NC	BCBS
2	D7811	OTHER	NC	MED-COST

General Provider Information

NPI Number	:	1861472771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAMELA F HAGAMAN PT,OCS

Provider Business Mailing Address
First Line	:	950 STATE FARM RD
Second Line	:
City	:	BOONE
State	:	NC
Zip	:	28607-5077
Country	:	US
Telephone Number	:	828-263-8344
Fax Number	:	828-263-8346

Provider Business Practice Location Address
First Line	:	950 STATE FARM RD
Second Line	:
City	:	BOONE
State	:	NC
Zip	:	28607-5021
Country	:	US
Telephone Number	:	828-263-8344
Fax Number	:	828-263-8346

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	02/10/2022

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Directions to “ MRS. PAMELA F HAGAMAN PT,OCS” Practice Location

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