Provider Demographics
NPI:1699759894
Name:SOWIZRAL, PAMELA A (DPM)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:A
Last Name:SOWIZRAL
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 1:435 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5852
Mailing Address - Country:US
Mailing Address - Phone:508-872-9288
Mailing Address - Fax:508-620-7368
Practice Address - Street 1:435 UNION AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5852
Practice Address - Country:US
Practice Address - Phone:508-872-9288
Practice Address - Fax:508-620-7368
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2017213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T87111Medicare UPIN
Y75014Medicare ID - Type Unspecified