Individual
MS. PAMELA R GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
45 COLPITTS RD, WESTON, MA 02493-1546
(781) 642-8877
(781) 642-1117
Mailing address
45 COLPITTS RD, WESTON, MA 02493-1546
(781) 642-8877
(781) 642-1117
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2403
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2403
PHYSICIAN ASSISTANT LICENSE
MA
Enumeration date
07/02/2008
Last updated
07/02/2008
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