Provider Demographics
NPI:1144224080
Name:PENNINGTON, ROBERT CLAY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLAY
Last Name:PENNINGTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4309 MEDICAL PARK DR
Mailing Address - Street 2:STE 200
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2388
Mailing Address - Country:US
Mailing Address - Phone:919-471-4484
Mailing Address - Fax:919-477-6131
Practice Address - Street 1:4309 MEDICAL PARK DR
Practice Address - Street 2:STE 200
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2388
Practice Address - Country:US
Practice Address - Phone:919-471-4484
Practice Address - Fax:919-477-6131
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC32027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD92779Medicare UPIN
NC213156DMedicare ID - Type Unspecified