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Individual

DR. PAMELA MICHELLE SPARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
514 S BAY RD, SYRACUSE, NY 13212-3627
(315) 458-1777
(315) 458-9661
Mailing address
514 S BAY RD, SYRACUSE, NY 13212-3627
(315) 458-1777
(315) 458-9661

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
0103300979
VA
213ES0131X
Foot Surgery Podiatrist
Primary
N006220-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2960630
NY
Enumeration date
05/07/2007
Last updated
02/23/2011
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