Individual
DR. PAMELA LOUISE LEIB
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
118 MAHANTONGO ST, POTTSVILLE, PA 17901-3009
(570) 628-3554
(570) 628-0194
Mailing address
118 MAHANTONGO ST, POTTSVILLE, PA 17901-3009
(570) 628-3554
(570) 628-0194
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD-028473-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03211900
CAPITAL BLUE CROSS
PA
05
—
1022890
—
PA
01
—
460243
HIGHMARK BLUE SHIELD
PA
01
—
A944323
VALUEOPTIONS
—
Enumeration date
09/08/2005
Last updated
07/08/2007
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