Provider Demographics
NPI:1104867704
Name:HATCHER, ROBERT M (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:HATCHER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98209
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-8209
Mailing Address - Country:US
Mailing Address - Phone:919-850-9111
Mailing Address - Fax:919-850-2499
Practice Address - Street 1:1418 E MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4812
Practice Address - Country:US
Practice Address - Phone:919-850-9111
Practice Address - Fax:919-850-2499
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908073Medicaid
NCT64022Medicare UPIN
NC8908073Medicaid
NC243050BMedicare ID - Type Unspecified