Individual
PAMELA HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2001 VAIL AVE, CHARLOTTE, NC 28207-1219
(704) 379-5956
(704) 379-6218
Mailing address
PO BOX 36351, CHARLOTTE, NC 28236-6351
(704) 377-5772
(704) 377-3389
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0039150
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8930935
—
NC
01
—
N39150
MEDICAID
SC
Enumeration date
10/14/2005
Last updated
08/08/2008
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