Healthcare Provider Details

I. General information

NPI: 1124048145
Provider Name (Legal Business Name): PAMELA N. COFFEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

6896 W SNOWVILLE RD
BRECKSVILLE OH
44141-3214
US

V. Phone/Fax

Practice location:
  • Phone: 517-337-0957
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301074886
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301074886
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: