Individual
PAMELA ANN PACQUIAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-6000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
65160
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110380A
—
GA
05
—
009959575
—
AL
Enumeration date
08/22/2006
Last updated
10/23/2020
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