Provider Demographics
NPI:1346209400
Name:RESNIK, ROBERT JOHN
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:RESNIK
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 1:930 SE CARY PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6134
Mailing Address - Country:US
Mailing Address - Phone:919-859-2566
Mailing Address - Fax:
Practice Address - Street 1:930 SE CARY PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518
Practice Address - Country:US
Practice Address - Phone:919-859-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38831207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2167202JMedicare ID - Type Unspecified
NCD95240Medicare UPIN