Provider Demographics
NPI:1609091537
Name:ZOUBEK, ROBERT A (MPT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:ZOUBEK
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 S HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4121
Mailing Address - Country:US
Mailing Address - Phone:336-917-6000
Mailing Address - Fax:336-917-6003
Practice Address - Street 1:1315 S HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4121
Practice Address - Country:US
Practice Address - Phone:336-917-6000
Practice Address - Fax:336-917-6003
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2502821Medicare ID - Type UnspecifiedMEDICARE