Provider Demographics
NPI:1811910516
Name:BROWN, PAMELA MEGATHLIN (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:MEGATHLIN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:MEGATHLIN
Other - Last Name:SCHEURICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 CABARRUS AVE E
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-3699
Mailing Address - Country:US
Mailing Address - Phone:855-743-2247
Mailing Address - Fax:
Practice Address - Street 1:6487 NC HIGHWAY 11 N
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:NC
Practice Address - Zip Code:27812-9797
Practice Address - Country:US
Practice Address - Phone:919-802-4589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36082207P00000X
NC2007-01812207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50005447OtherPASSPORT
KY64056096Medicaid
WV3810004962Medicaid
NC5908320Medicaid
KY000000233250OtherANTHEM
KY930124031OtherRR-MEDICARE
WV3000161OtherBWC
WV3810004962Medicaid
NC5908320Medicaid
NC2074940Medicare PIN