Provider Demographics
NPI:1740395136
Name:ERKSTAM, ROBERT PER WILLIAM (OTR)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PER WILLIAM
Last Name:ERKSTAM
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 GORDON RD STE H
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8424
Mailing Address - Country:US
Mailing Address - Phone:910-233-0730
Mailing Address - Fax:910-338-0424
Practice Address - Street 1:6626 GORDON RD STE H
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411
Practice Address - Country:US
Practice Address - Phone:910-798-4051
Practice Address - Fax:910-338-0424
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4588225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist