MEDICARE: PAMELA A RODOCOY M.D.

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
1	207R00000X	Internal Medicine Physician	35-07-7366-R	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110212271	OTHER	OH	MEDICARE RAILROADERS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000128632	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1902805336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA A RODOCOY M.D.

Provider Business Mailing Address
First Line	:	1207 W STATE ST
Second Line	:	SUITE N
City	:	ALLIANCE
State	:	OH
Zip	:	44601-4686
Country	:	US
Telephone Number	:	330-821-3244
Fax Number	:	330-868-5782

Provider Business Practice Location Address
First Line	:	1207 W STATE ST
Second Line	:	SUITE N
City	:	ALLIANCE
State	:	OH
Zip	:	44601-4686
Country	:	US
Telephone Number	:	330-821-3244
Fax Number	:	330-868-5782

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	03/30/2017

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Directions to “ PAMELA A RODOCOY M.D.” Practice Location

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