Provider Demographics
NPI:1083693287
Name:SANTAMARIA, PAMELA (MD)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:SANTAMARIA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13340 CALIFORNIA ST STE 201
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5255
Mailing Address - Country:US
Mailing Address - Phone:531-999-2670
Mailing Address - Fax:531-999-8136
Practice Address - Street 1:13340 CALIFORNIA ST STE 201
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5255
Practice Address - Country:US
Practice Address - Phone:531-999-2670
Practice Address - Fax:531-999-8136
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE221352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2551036Medicaid
NE10025242300Medicaid
91739OtherWELLMARK
NEH57912Medicare UPIN
NE10025242300Medicaid