Provider Demographics
NPI:1538185434
Name:PARHAM-VETTER, PAMELA CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:CHRISTINE
Last Name:PARHAM-VETTER
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 1:12312 W 168TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221
Mailing Address - Country:US
Mailing Address - Phone:445-444-1137
Mailing Address - Fax:620-432-5778
Practice Address - Street 1:12312 W 168TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221
Practice Address - Country:US
Practice Address - Phone:445-444-1137
Practice Address - Fax:620-432-5778
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0428370174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSH82520Medicare UPIN