Healthcare Provider Details

I. General information

NPI: 1477653988
Provider Name (Legal Business Name): PAMELA D ROSS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 ST PAUL DR STE 104
CHAMBERSBURG PA
17201-1035
US

IV. Provider business mailing address

785 5TH AVE STE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-263-8463
  • Fax: 717-263-1103
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-217-4217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052608
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: