Provider Demographics
NPI:1730347634
Name:PAYNE, VICTORIA MITCHELL (MD, MS)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:MITCHELL
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:943 W ANDREWS AVE STE H
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2562
Mailing Address - Country:US
Mailing Address - Phone:252-433-0061
Mailing Address - Fax:252-738-2460
Practice Address - Street 1:943 W ANDREWS AVE STE H
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2562
Practice Address - Country:US
Practice Address - Phone:252-433-0061
Practice Address - Fax:252-738-2460
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2003003942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134XPMedicaid
NC2020994Medicare PIN
NC89134XPMedicaid