Provider Demographics
NPI:1457668774
Name:BROWN, PAMELA
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W LIBERTY ST
Mailing Address - Street 2:STE 213
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4865
Mailing Address - Country:US
Mailing Address - Phone:803-236-2152
Mailing Address - Fax:
Practice Address - Street 1:410 W LIBERTY ST
Practice Address - Street 2:STE 213
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4865
Practice Address - Country:US
Practice Address - Phone:803-236-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle