Provider Demographics
NPI:1225127459
Name:RICH, ROBERT L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:RICH
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-0517
Mailing Address - Country:US
Mailing Address - Phone:910-862-5500
Mailing Address - Fax:910-862-2107
Practice Address - Street 1:300A EAST MCKAY STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337
Practice Address - Country:US
Practice Address - Phone:910-862-5500
Practice Address - Fax:910-862-2107
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC29651207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF08812Medicare UPIN