Provider Demographics
NPI:1447373006
Name:ROYAL, PAMELA J (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:J
Last Name:ROYAL
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 1:505 W LEIGH ST
Mailing Address - Street 2:SUITES 304 & 306
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-3200
Mailing Address - Country:US
Mailing Address - Phone:804-775-0957
Mailing Address - Fax:804-775-0959
Practice Address - Street 1:505 W LEIGH ST
Practice Address - Street 2:SUITES 304 & 306
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3200
Practice Address - Country:US
Practice Address - Phone:804-775-0957
Practice Address - Fax:804-775-0959
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043629174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E45972Medicare UPIN