Individual
PAMELA B MAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 789-7025
(843) 789-6109
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 789-7025
(843) 789-6109
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
APN712
SC
363L00000X
Nurse Practitioner
Primary
712
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0749
—
SC
01
—
P00648613
RAILROAD MEDICARE #
SC
Enumeration date
05/27/2006
Last updated
12/29/2016
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