Provider Demographics
NPI:1356325849
Name:VIRE, ROBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:VIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 CALLIES CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-9624
Mailing Address - Country:US
Mailing Address - Phone:252-813-0820
Mailing Address - Fax:
Practice Address - Street 1:2036 CALLIES CT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-9624
Practice Address - Country:US
Practice Address - Phone:252-813-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01054208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE436023590OtherMEDCOST
NCP00240342OtherRAILROAD MEDICARE
NC5901461Medicaid
NC13989OtherBCBSNC
NC1493662OtherCIGNA HEALTHCARE
NC13989OtherBCBSNC
NC5901461Medicaid