Individual
PAMELA A GEORGESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
30170 23 MILE RD, CHESTERFIELD, MI 48047-2190
(586) 949-5900
(586) 949-5922
Mailing address
30170 23 MILE RD, CHESTERFIELD, MI 48047-2190
(586) 949-5900
(586) 949-5922
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
5101008579
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4326232
AETNA
MI
01
—
5500466
BCBSM
MI
01
—
C2983
MCARE
MI
01
—
PG008579
BCBSM OTHER IDENTIFIER
MI
Enumeration date
06/16/2005
Last updated
07/14/2007
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