Provider Demographics
NPI:1902816713
Name:KEARNEY, PAMELA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NIH NINDS MNB LSS 10 CENTER DRIVE
Mailing Address - Street 2:BUILDING 10 ROOM 5D38
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1416
Mailing Address - Country:US
Mailing Address - Phone:301-496-9365
Mailing Address - Fax:
Practice Address - Street 1:NIH NINDS MNB LSS-10 CENTER DRIVE
Practice Address - Street 2:BUILDING 10 ROOM 5D38
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1416
Practice Address - Country:US
Practice Address - Phone:301-496-9365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30736207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC010991M83Medicare ID - Type Unspecified
H27068Medicare UPIN