Provider Demographics
NPI:1396287868
Name:PUWO, PAMELA D (HHA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:PUWO
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MORAN DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-6444
Mailing Address - Country:US
Mailing Address - Phone:202-644-3406
Mailing Address - Fax:
Practice Address - Street 1:1901 MORAN DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-6444
Practice Address - Country:US
Practice Address - Phone:202-644-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC193400000XMedicaid