Provider Demographics
NPI:1043306244
Name:KOEHLER, ROBERT N (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:N
Last Name:KOEHLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14883
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-4883
Mailing Address - Country:US
Mailing Address - Phone:336-282-0376
Mailing Address - Fax:336-282-0379
Practice Address - Street 1:3800 ROBERT PORCHER WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2190
Practice Address - Country:US
Practice Address - Phone:336-282-0376
Practice Address - Fax:336-282-0379
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC26288207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC49909OtherBCBS OF NC
NC0103567OtherUHC OF NC
NC8949909Medicaid
NC19074OtherPARTNERS MEDICARE
NC26577OtherMEDCOST
NC202972FMedicare PIN
NC0103567OtherUHC OF NC