Provider Demographics
NPI:1538144209
Name:ERDIN, ROBERT ALEXANDER III (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALEXANDER
Last Name:ERDIN
Suffix:III
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 1:4601 PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2000
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL PARK DR STE 400
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0939
Practice Address - Country:US
Practice Address - Phone:704-786-1108
Practice Address - Fax:704-782-1826
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401495207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1405POtherBCBC OF NC
2420568001OtherCIGNA HEALTHCARE
5643601OtherFIRST HEALTH
182459OtherMEDCOST
7112718OtherAETNA US HEALTHCARE
CCNOther5643601
NC5902477Medicaid
SCQ0149KMedicaid
2420568001OtherCIGNA HEALTHCARE
I05677Medicare UPIN
5643601OtherFIRST HEALTH