# PAM PHYSICIAN ENTERPRISE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275338501
- **Authorized official:** ANTHONY MISITANO (PRESIDENT)
- **Authorized official phone:** (717) 731-9660

## Contact information

- **Practice address:** 12911 W 40TH AVE, GOLDEN, CO 80401-2696
- **Practice address phone:** (303) 425-4500
- **Mailing address:** PO BOX 206478, DALLAS, TX 75320-6478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/19/2025
- **Last updated:** 02/19/2025