Provider Demographics
NPI:1295749596
Name:BINNS-GIBSON, PAMELA M (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:BINNS-GIBSON
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-1700
Mailing Address - Fax:704-316-1701
Practice Address - Street 1:2610 WEST ARROWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273
Practice Address - Country:US
Practice Address - Phone:704-316-1700
Practice Address - Fax:704-316-1701
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200501505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904685Medicaid
NC2056928Medicare ID - Type Unspecified
NCI62218Medicare UPIN