Individual provider · Type 1 NPI
Pamela Granville, PA-C
Surgical Physician Assistant · Boston, MA
NPI number
1487922191
Active
Practice location
300 Longwood Ave, Otolaryngology Department
Boston, MA 02115-5724
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA4292 |
| Surgical Physician Assistant Primary | 363AS0400X | 301719 (MA) |
Surgical Physician Assistant: Definition to come...
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About NPI 1487922191
Pamela Granville, PA-C's National Provider Identifier is 1487922191, issued on Dec 8, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Boston, MA. The record was last updated on Aug 22, 2019.