Provider Demographics
NPI:1962562991
Name:DARNELL, PAMELA KETRON (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KETRON
Last Name:DARNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:BLANCHE
Other - Last Name:KETRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1735 POTOMAC GREENS DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-6232
Mailing Address - Country:US
Mailing Address - Phone:937-626-4197
Mailing Address - Fax:
Practice Address - Street 1:1735 POTOMAC GREENS DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-6232
Practice Address - Country:US
Practice Address - Phone:937-626-4197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.060949208000000X
OK25448208000000X
VA0101050631208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics