Healthcare Provider Details

I. General information

NPI: 1659741916
Provider Name (Legal Business Name): PAMELA DURNING MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 RIDGELY AVE SUITE 204
ANNAPOLIS MD
21401-1081
US

IV. Provider business mailing address

20404 POWELL FARM PL
BROOKEVILLE MD
20833-2122
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-1588
  • Fax: 443-458-6775
Mailing address:
  • Phone: 410-266-1588
  • Fax: 443-458-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA DURNING
Title or Position: OWNER
Credential: MD
Phone: 917-443-4586