Healthcare Provider Details

I. General information

NPI: 1689894941
Provider Name (Legal Business Name): PAMELA LYNNE WALKER PHARM.D., BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAMELA LYNNE LADA PHARM.D., BCPS

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DR SPC 5008
ANN ARBOR MI
48109-5008
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DR SPC 5008
ANN ARBOR MI
48109-5008
US

V. Phone/Fax

Practice location:
  • Phone: 734-647-2359
  • Fax: 734-936-7027
Mailing address:
  • Phone: 734-647-2359
  • Fax: 734-936-7027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302032059
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: