Individual
PAMELA J. FALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2861
(706) 721-1459
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-8402
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
038751
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000618043A
—
GA
05
—
G38751
—
SC
Enumeration date
09/07/2006
Last updated
03/31/2011
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