Provider Demographics
NPI:1093831570
Name:PAMELA J. WHITNEY, M.D, P.A.
Entity Type:Organization
Organization Name:PAMELA J. WHITNEY, M.D, P.A.
Other - Org Name:PAMELA J. WHITNEY, M.D., P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-872-0940
Mailing Address - Street 1:3320 EXECUTIVE DR
Mailing Address - Street 2:SUITE 218
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7445
Mailing Address - Country:US
Mailing Address - Phone:919-872-0940
Mailing Address - Fax:919-872-0926
Practice Address - Street 1:3320 EXECUTIVE DR
Practice Address - Street 2:SUITE 218
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7445
Practice Address - Country:US
Practice Address - Phone:919-872-0940
Practice Address - Fax:919-872-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27755174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1417957077OtherINDIVIDUAL NPI NUMBER
NC8987240Medicaid
NC1417957077OtherINDIVIDUAL NPI NUMBER
NCC81706Medicare UPIN