Provider Demographics
NPI:1366578205
Name:USHER, PAMELA (AA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:USHER
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7956 VAUGHN RD
Mailing Address - Street 2:# 165
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-6625
Mailing Address - Country:US
Mailing Address - Phone:912-429-9020
Mailing Address - Fax:912-352-0793
Practice Address - Street 1:6605 ABERCORN ST
Practice Address - Street 2:ST 108
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5815
Practice Address - Country:US
Practice Address - Phone:912-354-5357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001952367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant