Provider Demographics
NPI:1386637247
Name:ROMINGER, ROBERT L III (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:ROMINGER
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3077
Mailing Address - Country:US
Mailing Address - Phone:336-723-1205
Mailing Address - Fax:336-773-0332
Practice Address - Street 1:2910 BRIARCLIFF RD
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3077
Practice Address - Country:US
Practice Address - Phone:336-723-1205
Practice Address - Fax:336-773-0332
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2160103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000130Medicaid
VA1386637247Medicaid
NC0443QOtherBLUECROSS BLUESHIELD OF N
NC194024OtherMEDCOST
WV3810010806Medicaid
NC44687OtherPARTNERS
SCPSQ973Medicaid
WV3810010806Medicaid
NC6000130Medicaid