Provider Demographics
NPI:1528005824
Name:SYPHER, ROBERT VAN CLEVE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:VAN CLEVE
Last Name:SYPHER
Suffix:JR
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 1:2718 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-3633
Mailing Address - Country:US
Mailing Address - Phone:336-375-1007
Mailing Address - Fax:336-375-9615
Practice Address - Street 1:2718 HENRY ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-3633
Practice Address - Country:US
Practice Address - Phone:336-375-1007
Practice Address - Fax:336-375-9615
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26993207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC81320OtherBCBSNC
NC8981320Medicaid
C81521Medicare UPIN
NC8981320Medicaid