Healthcare Provider Details

I. General information

NPI: 1629169206
Provider Name (Legal Business Name): PAMELA E NETUSCHIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6580 S MCCARRAN BLVD SUITE A
RENO NV
89509-6160
US

IV. Provider business mailing address

6580 S MCCARRAN BLVD SUITE A
RENO NV
89509-6160
US

V. Phone/Fax

Practice location:
  • Phone: 775-432-1343
  • Fax: 775-324-0858
Mailing address:
  • Phone: 775-432-1343
  • Fax: 775-324-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number8595
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: