Individual
PAMELA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
102 IRVING ST NW, WASHINGTON, DC 20010-2921
(202) 877-1170
Mailing address
102 IRVING ST NW, WASHINGTON, DC 20010-2921
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
19091
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112522
KAISER
—
01
—
411438
MAMSI
—
01
—
4398916
AETNA
—
01
—
494959
NCPPO
—
01
—
520846-01
BS OF MD
MD
01
—
5460-0036
BS OF NCA
DC
01
—
7639069003
CIGNA
—
01
—
852241
AETNA HMO
—
Enumeration date
03/10/2006
Last updated
12/10/2007
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