Most Relevant Information
Provider Data
| NPI Number: | 1003305533 |
| Provider Name: | PAMELA MARIE DEWILDE DO (AS OF 6/17/18) |
| Entity Type: | Individual |
| Taxonomy Code: | 204D00000X |
| Specialty: | Neuromusculoskeletal Medicine & OMM |
| License Number: | 3647 |
Most Important Dates
| Enumeration Date: | 05/10/2018 |
| Last Updated: | 09/20/2022 |
Provider Practice Location
1464 JEFFERSON ST N
LEWISBURG
WV
249011380
Practice Location Phone/Fax
| Phone: | 3046453220 |
| Fax: | 8444794545 |
Provider Mailing Location
1464 JEFFERSON ST N
LEWISBURG
WV
249011380
Provider Mailing Phone/Fax
| Phone: | 3046453220 |
| Fax: | 8444794545 |