Provider Demographics
NPI:1194796623
Name:CULP, PAMELA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:JEAN
Last Name:CULP
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:MECKLENBURG RADIOLOGY ASSOCIATES, P.A.
Mailing Address - Street 2:3623 LATROBE DR, SUITE 216
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211
Mailing Address - Country:US
Mailing Address - Phone:704-332-1291
Mailing Address - Fax:704-332-5206
Practice Address - Street 1:MECKLENBURG RADIOLOGY ASSOCIATES, P.A.
Practice Address - Street 2:3623 LATROBE DR, SUITE 216
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-332-1291
Practice Address - Fax:704-332-5206
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC276692085R0202X
SC133472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC892644BMedicaid
NC2159135CMedicare ID - Type Unspecified
NC892644BMedicaid