Pavelock, Richard M
Pavelock, Richard M is an individual health care provider with primary practice located at 190 Commerce Blvd , Statesville NC 28625-8526. He recently has 5 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, Allopathic & Osteopathic Physicians / Addiction Medicine. Other Service Providers / Specialist is his primary health care specialty. Pavelock, Richard M can be contacted via phone (704) 838-0516.Contact Information
Primary practice address
190 Commerce Blvd
Statesville NC 28625-8526
Phone: (704) 838-0516
Fax: (704) 838-0565
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 39460 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 39460 | North Carolina |
| Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities | 2084P0005X | 39460 | North Carolina |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 39460 | North Carolina |
Profile Details
| NPI number | 1487739579 |
|---|---|
| LBN Legal business name | Pavelock, Richard M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Apr 19th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487739579 | NPPES |
| North Carolina | Other | 66248 | BCBS OF NC |
| North Carolina | MEDICAID | 8966248 | BCBS OF NC |
| North Carolina | Other | P00219696 | BCBS OF NC |
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