Individual
MRS. PAMELA S. STALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
63 CORPORATE CENTER DR, SCOTT DEPOT, WV 25560-7841
(304) 691-8870
(304) 691-1665
Mailing address
63 CORPORATE CENTER DR, SCOTT DEPOT, WV 25560-7841
(304) 691-8870
(304) 691-1665
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
16984
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107899000
—
WV
Enumeration date
08/10/2005
Last updated
12/23/2021
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