Individual
RICHARD M PAVELOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2632 FINES CREEK DR, STATESVILLE, NC 28625-4441
(704) 838-0516
(704) 838-0565
Mailing address
2632 FINES CREEK DR, STATESVILLE, NC 28625-4441
(704) 838-0516
(704) 838-0565
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207Q00000X
Family Medicine Physician
39460
NC
207R00000X
Internal Medicine Physician
39460
NC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
39460
NC
2084P0005X
Neurodevelopmental Disabilities Physician
39460
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66248
BCBS OF NC
NC
05
—
8966248
—
NC
01
—
P00219696
RAILROAD MEDICARE
NC
Enumeration date
10/26/2006
Last updated
08/26/2024
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