Healthcare Provider Details

I. General information

NPI: 1508884040
Provider Name (Legal Business Name): PAMELA SUSAN LOTKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 4TH ST NE
WASHINGTON DC
20002-3431
US

IV. Provider business mailing address

1225 4TH ST NE
WASHINGTON DC
20002-3431
US

V. Phone/Fax

Practice location:
  • Phone: 202-347-8512
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0080283
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number30503
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD042881
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: