Provider Demographics
NPI:1639621253
Name:CHRISTENBERY, ROBERT III (PA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CHRISTENBERY
Suffix:III
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-367-4800
Mailing Address - Fax:704-316-3025
Practice Address - Street 1:2801 RANDOLPH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1047
Practice Address - Country:US
Practice Address - Phone:704-367-4800
Practice Address - Fax:704-316-3025
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-06746363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant