Provider Demographics
NPI:1811199763
Name:CHRISTIAN, ROBERT BOURKE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BOURKE
Last Name:CHRISTIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF NORTH CAROLINA C I D D
Mailing Address - Street 2:CB #7255
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-843-2517
Mailing Address - Fax:919-966-2230
Practice Address - Street 1:1450 RALEIGH RD
Practice Address - Street 2:#100
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8833
Practice Address - Country:US
Practice Address - Phone:919-843-2517
Practice Address - Fax:919-966-2230
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-015692084P0804X, 208000000X
RIMD123492084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2008-01569OtherNORTH CAROLINA MEDICAL LICENSE
RIMD12349OtherMEDICAL LICENSE