Provider Demographics
NPI:1760443188
Name:HAMP, ROBERT CHARLES
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHARLES
Last Name:HAMP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8316 MEDICAL PLAZA DR STE E
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-6704
Mailing Address - Country:US
Mailing Address - Phone:704-547-1551
Mailing Address - Fax:
Practice Address - Street 1:8316 MEDICAL PLAZA DR STE E
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-6704
Practice Address - Country:US
Practice Address - Phone:704-547-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1794152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89093HHMedicaid
NC093HHOtherBCBS
NC2031028OtherUNITED HEALTHCARE
NC2031028OtherUNITED HEALTHCARE
NC0485250003Medicare NSC
NC093HHOtherBCBS
NCU80981Medicare UPIN
NC89093HHMedicaid
NC0485250001Medicare NSC
NC2471845FMedicare PIN