Provider Demographics
NPI:1063617645
Name:SAUER, PAMELA (DPM)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:SAUER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 COOL CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-6127
Mailing Address - Country:US
Mailing Address - Phone:703-727-8972
Mailing Address - Fax:717-327-4666
Practice Address - Street 1:208 COOL CREEK WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-6127
Practice Address - Country:US
Practice Address - Phone:703-727-8972
Practice Address - Fax:717-327-4666
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO551213EP1101X
MD01239213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC336051Medicare UPIN