| Doctor Name: | PAMELA CORSON |
| NPI Number: | 1255534921 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 9194 |
| Business Practice Address: | 971 W Moana Ln Reno, NV - 895094844 |
| Business Phone Number: | 7758297999 |
| Business Fax Number: | |
| Mailing Address: | 3495 Lakeside Dr, 205 RENO |
| State: | NV |
| Postal Code: | 895094841 |
| Phone Number: | 7758297999 |
| Fax Number: | |
| NPI Enumeration Date: | 06/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332900000X |
| License Number: | 9194 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Non-Pharmacy Dispensing Site |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |