Provider Demographics
NPI:1164725669
Name:ROBINSON, ROBERT LEE
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
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 522
Mailing Address - Street 2:
Mailing Address - City:SHERRILLS FORD
Mailing Address - State:NC
Mailing Address - Zip Code:28673-0522
Mailing Address - Country:US
Mailing Address - Phone:704-506-2476
Mailing Address - Fax:
Practice Address - Street 1:20119 HENDERSON RD
Practice Address - Street 2:F
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5886
Practice Address - Country:US
Practice Address - Phone:704-506-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver