Individual
DR. PAMELA ENJETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1535 SLATE CREEK RD, GRUNDY, VA 24614-6974
(276) 935-1370
Mailing address
1535 SLATE CREEK RD, GRUNDY, VA 24614-6974
(276) 935-1370
(276) 935-1370
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
101041384
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005
CAREFIRST BLUE CROSS
VA
05
—
005783429
—
VA
01
—
050019991
RAILROAD MEDICARE
VA
01
—
054846
ANTHEM BLUE CROSS
VA
01
—
VV1431A
MEDICARE ID
VA
Enumeration date
09/19/2005
Last updated
03/21/2013
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