Individual
PAMELA MABEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4911 S ARROWHEAD DR, SUITE 200, INDEPENDENCE, MO 64055-7005
(816) 795-9595
(816) 795-1188
Mailing address
4911 S ARROWHEAD DR, SUITE 200, INDEPENDENCE, MO 64055-7005
(816) 795-9595
(816) 795-1188
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
107790
MO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
107790
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100151230 C
—
KS
05
—
100151230B
—
KS
05
—
208995803
—
MO
Enumeration date
09/15/2005
Last updated
09/20/2016
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