Provider Demographics
NPI:1568626133
Name:HARRIS, PAMELA LIN (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:LIN
Last Name:HARRIS
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 1:439 WESTWOOD SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1532
Mailing Address - Country:US
Mailing Address - Phone:910-605-6697
Mailing Address - Fax:833-340-7315
Practice Address - Street 1:439 WESTWOOD SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1532
Practice Address - Country:US
Practice Address - Phone:910-286-1923
Practice Address - Fax:833-340-7315
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-02028207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ487672Medicaid
AZZ141120Medicare Oscar/Certification