Provider Demographics
NPI:1285781674
Name:WARNER, PAMELA G (M D)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:G
Last Name:WARNER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1002 N CHURCH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1439
Mailing Address - Country:US
Mailing Address - Phone:336-235-3060
Mailing Address - Fax:336-235-3079
Practice Address - Street 1:1002 N CHURCH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1439
Practice Address - Country:US
Practice Address - Phone:336-235-3060
Practice Address - Fax:336-235-3079
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9801549208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891219YMedicaid
NC891219YMedicaid