Individual
PAMELA SUE GULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3501 BERRYWOOD DR, COLUMBIA, MO 65201-6584
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
R4P17
MO
2084P0800X
Psychiatry Physician
Primary
R4P17
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
824000228
MEDICARE
MO
Enumeration date
12/28/2006
Last updated
09/20/2022
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