Provider Demographics
NPI:1578662144
Name:MEYER, ROBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:MEYER
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 1:208 N HERMAN ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-3810
Mailing Address - Country:US
Mailing Address - Phone:919-734-5600
Mailing Address - Fax:919-734-5607
Practice Address - Street 1:208 N HERMAN ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3810
Practice Address - Country:US
Practice Address - Phone:919-734-5600
Practice Address - Fax:919-734-5607
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7958772Medicaid
NC58772OtherBC/BS PROVIDER NUMBER
NC202039Medicare PIN
NC58772OtherBC/BS PROVIDER NUMBER