| Doctor Name: | PAMELA P FAHR |
| NPI Number: | 1992822845 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MN, C-FNP |
| License Number: | R163566 |
| Business Practice Address: | 2772 Rutland Rd Davidsonville, MD - 210351228 |
| Business Phone Number: | 4436071033 |
| Business Fax Number: | |
| Mailing Address: | 1715 Denton Ct, CROFTON |
| State: | MD |
| Postal Code: | 211141913 |
| Phone Number: | 4104513268 |
| Fax Number: | |
| NPI Enumeration Date: | 03/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R163566 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |