Provider Demographics
NPI:1174619001
Name:WRIGHT-ETTER, PAMELA J (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:J
Last Name:WRIGHT-ETTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:J
Other - Last Name:WRIGHT-MESCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3623 LATROBE DR
Mailing Address - Street 2:SUITE 121
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4864
Mailing Address - Country:US
Mailing Address - Phone:704-907-0244
Mailing Address - Fax:704-344-8702
Practice Address - Street 1:3623 LATROBE DR
Practice Address - Street 2:SUITE 121
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4864
Practice Address - Country:US
Practice Address - Phone:704-375-7579
Practice Address - Fax:704-344-8704
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC329172084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE-52618Medicare UPIN
NC898944CMedicaid
NC213251CMedicare PIN
SCN32917Medicaid
NC213251DMedicare PIN