Healthcare Provider Details

I. General information

NPI: 1144549080
Provider Name (Legal Business Name): AMELIA MARIE PASLEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

50 N PERRY ST
PONTIAC MI
48342-2217
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-0398
  • Fax:
Mailing address:
  • Phone: 248-338-5310
  • Fax: 248-338-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101018414
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberH79792
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: