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General NPI Number Information
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NPI Number | 1952360380
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Entity Type | Individual
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Provider Name | PAMELA J DEBERGHES MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 5850 CHAMPIONSHIP VW STE D EL PASO COUNTY EMPLOYEE HEALTH CENTER
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-2506
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Country | US
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Telephone | 719-520-7600
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Fax | 719-520-7610
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Provider Business Mailing Address
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Address Line | 1675 GARDEN OF THE GODS RD SUITE 1053 EPC EMPLOYEE HEALTH CENTER
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-9444
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Country | US
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Telephone | 719-520-7600
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Fax | 719-520-7610
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36309
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License Number State | CO
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