Healthcare Provider Details

I. General information

NPI: 1891819132
Provider Name (Legal Business Name): PAMELA STIRRAT CALLIARI M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 CHAPANOKE RD SUITE 101
RALEIGH NC
27603-3433
US

IV. Provider business mailing address

821 WAKE FOREST RD
RALEIGH NC
27604-1219
US

V. Phone/Fax

Practice location:
  • Phone: 919-662-4600
  • Fax:
Mailing address:
  • Phone: 919-828-5625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3167
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: