Provider Demographics
NPI:1487659728
Name:COKER, ROBERT A (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:COKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5422
Mailing Address - Country:US
Mailing Address - Phone:410-543-7536
Mailing Address - Fax:410-543-7272
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5422
Practice Address - Country:US
Practice Address - Phone:410-543-7536
Practice Address - Fax:410-543-7272
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0056197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD162803800Medicaid
MD60801202OtherBCSB OF MD
MDP00414182OtherRAILROAD MEDICARE
MD162803800Medicaid
MDMD451MMedicare PIN
MDP00414182OtherRAILROAD MEDICARE