PAMELA J WYMORE (NPI# 1760429138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760429138 |
| Entity Type | Individual |
| Full Name | PAMELA J WYMORE |
| Credential | M.D. |
| Practice Address |
166 4th Street E St. Paul MN 55101 |
| Practice Telephone | 6512922000 |
| Practice Fax Number | 6512922136 |
| Mailing Telephone | 6512922000 |
| Mailing Fax Number | 6512922136 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
37571 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | PREFERRED ONE | 1030863 | 01 |
| MN | BLUE CROSS | 502T1WY | 01 |
| MN | HEALTHPARTNERS | HP43094 | 01 |
| MN | RAILROAD MEDICARE MN | P00201776 | 01 |
| MN | AMERICA'S PPO | 2182694 | 01 |
| MN | MEDICA | 1603279 | 01 |
| MN | BLUE CROSS | 502T0WY | 01 |
| MN | 089807400 | 05 | |
| WI | 34234600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7505 Metro Blvd Ste 400, Edina, MN 554393010 | (612) 573-2200 | 6125732274 |
| Street Address |
166 4TH STREET E |
| City | ST. PAUL |
| State | MN |
| Zip Code | 55101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1689211443 | Siripa Min | Nurse Anesthetist, Certified Registered | 640 Jackson Street Mail Stop 11503, St. Paul, MN 55101 | 2019-11-28 |
| 1922590488 | Diane Mcleod | Physician Assistant | Healthpartners Regions Specialty Clinics, 640 Jackson St - Mail Stop 11109e, Saint Paul, MN 55101 | 2018-05-31 |
| 1699284919 | Eric Mcgillis | Emergency Medicine | Regions Hospital - Emergency Medicine, 11102f, 640 Jackson St, St Paul, MN 55101 | 2017-09-29 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1992182323 | Theresa Annette Cashdollar-powell | Social Worker | 640 Jackson, St Paul, MN 55101 | 2015-05-06 |
| 1770986101 | Margaret Augusta Cutter | Physician Assistant | 200 Univeristy Ave E, Saint Paul, MN 55101 | 2014-09-30 |
| 1851641419 | Lisa Rae Caturia | Occupational Therapy Assistant | 640 Jackson St, 8th Floor, St Paul, MN 55101 | 2012-09-11 |
| 1558619478 | Rph On The Go | Community/Behavioral Health | 172 E 6th Street, 704, Saint Paul, MN 55101 | 2012-08-27 |
| 1184994212 | Duyen Truong | Pharmacist | 604 Jackson Street, St. Paul, MN 55101 | 2012-01-05 |
| Find all providers in zip 55101 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669438610 | Douglas Houston Sheafor | Radiology | 166 4th St. E., Ste. 100, St. Paul, MN 55101 | 2006-04-26 |
| 1326455239 | Justin Nelson | Radiology | 250 Thompson St., St. Paul, MN 55102 | 2014-07-14 |
| 1750721593 | David Michael Miller | Radiology | 250 Thompson St., St. Paul, MN 55102 | 2013-06-25 |
| 1679916423 | Leslie Teng | Radiology | 250 Thompson St., St. Paul, MN 55102 | 2013-04-11 |
| 1609118710 | Matthew Stephen Manganaro | Radiology | 250 Thompson St., St. Paul, MN 55102 | 2013-03-27 |
| 1326307760 | Zachary Brandon Royce | Radiology | 250 Thompson St., St. Paul, MN 55102-2370 | 2012-05-04 |
| 1033417571 | Jason John Carroll | Radiology | 250 Thompson St., St. Paul, MN 55102 | 2011-03-08 |
| 1396972584 | Brendan M O'shea | Radiology | 250 Thompson St., St. Paul, MN 55102 | 2009-06-16 |
| 1831330851 | Lashonda Watts Soma | Radiology | 166 4th St. E., St. Paul, MN 55101 | 2009-03-20 |
| 1467667774 | Craig Paul Rodriguez | Radiology | 250 Thompson St., St. Paul, MN 55102-2370 | 2007-05-11 |
| Find all providers in ST. PAUL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.