MEDICARE: PAMELA DIANN CAMPBELL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	103291	NC

General Provider Information

NPI Number	:	1609890664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA DIANN CAMPBELL PA-C

Provider Business Mailing Address
First Line	:	5501 FORTUNES RIDGE DR STE P
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-6102
Country	:	US
Telephone Number	:	919-391-7202
Fax Number	:	919-391-7203

Provider Business Practice Location Address
First Line	:	5501 FORTUNES RIDGE DR STE P
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-6102
Country	:	US
Telephone Number	:	919-391-7202
Fax Number	:	919-391-7203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	11/05/2025

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