Provider Demographics
NPI:1447366984
Name:FEELEY, PAMELA (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:FEELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 CENTER POINT WAY UNIT 83147
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20883-7507
Mailing Address - Country:US
Mailing Address - Phone:301-648-6300
Mailing Address - Fax:
Practice Address - Street 1:618 CENTER POINT WAY UNIT 83147
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20883-7507
Practice Address - Country:US
Practice Address - Phone:301-648-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2024-07-19
Deactivation Date:2024-06-28
Deactivation Code:
Reactivation Date:2024-07-18
Provider Licenses
StateLicense IDTaxonomies
MDD00512672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD080102000Medicaid
MDG62407Medicare UPIN
MD953095Medicare ID - Type UnspecifiedMEDICARE