Provider Demographics
NPI:1235117805
Name:SHIRLEY, ROBERT EDWARD LEE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDWARD LEE
Last Name:SHIRLEY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:870 STATE FARM RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4861
Mailing Address - Country:US
Mailing Address - Phone:828-264-5464
Mailing Address - Fax:828-264-5488
Practice Address - Street 1:870 STATE FARM RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4861
Practice Address - Country:US
Practice Address - Phone:828-264-5464
Practice Address - Fax:828-264-5488
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC20068207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8975950Medicaid
NC8975950Medicaid
NCC86427Medicare UPIN