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NPI Code Detail

MEDICARE: PAMELA DAWN LYNCH OD

MEDICARE: PAMELA DAWN LYNCH OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist4901004698MI

General Provider Information

NPI Number : 1396007951
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA DAWN LYNCH OD
Provider Business Mailing Address
First Line : 2200 JEFFERSON AVE
Second Line : 4TH FLOOR
City : TOLEDO
State : OH
Zip : 43604-7101
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1180 N MONROE ST
Second Line :
City : MONROE
State : MI
Zip : 48162-3190
Country : US
Telephone Number : 734-243-5300
Fax Number : 734-243-3236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 10/23/2012

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Directions to “ PAMELA DAWN LYNCH OD” Practice Location

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