Individual
PAMELA LESTER GWATHMEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
142 SMITHFIELD ROAD, SAINT STEPHENS CHURCH, VA 23148-0041
(804) 769-0103
(804) 769-0508
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 769-0508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101038630
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005823714
—
VA
01
—
10000353
OPTIMA
VA
01
—
12465
CARENET
VA
01
—
396694
ANTHEM
VA
01
—
4136176
AETNA
VA
01
—
6967223
CIGNA
VA
01
—
96465
SOUTHERN HEALTH
VA
Enumeration date
07/05/2006
Last updated
06/23/2021
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