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Individual

PAMELA M. WEINHOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7405 RENNER RD, KU MEDWEST, SHAWNEE, KS 66217-9414
(913) 588-8400
(913) 588-8413
Mailing address
2330 SHAWNEE MISSION PKWY, MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312, WESTWOOD, KS 66205-2005
(913) 588-9000
(913) 588-9822

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-25577
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10001313101
CHP PROVIDER NUMBER
05
100423720B
KS
01
157659XX
PREFERRED CARE OF NY
01
31491019
BCBS
01
481159444
JAYHAWK TAX ID
01
506790
FIRSTGUARD
01
7501135
AETNA
01
930121323
RR MEDICARE
Enumeration date
06/14/2006
Last updated
11/20/2009
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