Provider Demographics
NPI:1134367394
Name:STOVER, PAMELA BARONE (DPM)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:BARONE
Last Name:STOVER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1036 BRANCHVIEW DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0112
Mailing Address - Country:US
Mailing Address - Phone:704-886-1918
Mailing Address - Fax:704-257-2049
Practice Address - Street 1:600 5TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4263
Practice Address - Country:US
Practice Address - Phone:828-697-1343
Practice Address - Fax:828-697-3224
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC552213ES0131X, 213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00897454OtherRR MEDICARE
NCP00897454OtherRR MEDICARE