Provider Demographics
NPI:1780640482
Name:STIFLER, ROBERT BAILEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BAILEY
Last Name:STIFLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4022 FREEDOM LAKE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:919-477-2202
Mailing Address - Fax:919-471-2270
Practice Address - Street 1:4022 FREEDOM LAKE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704
Practice Address - Country:US
Practice Address - Phone:919-477-2202
Practice Address - Fax:919-471-2270
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29679208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC80036OtherBCBS STATE FEDERAL NC HEA
7935131OtherAETNA
8980036OtherCAROLINA ACCESS NC
NC8980036Medicaid
1257181OtherUNITED HEALTHCARE
243194OtherMAMSI ALLIANCE
A6297OtherMEDCOST
NC80036OtherBCBS STATE FEDERAL NC HEA