Provider Demographics
NPI:1922042662
Name:DEUCHER, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:DEUCHER
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 1:334 MILL CREEK RD STE D
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327-6506
Mailing Address - Country:US
Mailing Address - Phone:910-725-0809
Mailing Address - Fax:910-725-2018
Practice Address - Street 1:334 MILL CREEK RD STE D
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-6506
Practice Address - Country:US
Practice Address - Phone:910-725-0809
Practice Address - Fax:910-725-2018
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400043207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC28347OtherBC/BS NC PROVIDER#
NC80137OtherMEDCOST PROVIDER#
NC8928347Medicaid
NCFH1000105OtherFIRSTCAROLINACARE PROV.#
SCN00043OtherSC MEDICAID PROVIDER#
NC0403943OtherEVERCARE
NC110106122OtherPALMETTO GBA PROVIDER#
NC28347OtherBC/BS NC PROVIDER#
NC2209340Medicare ID - Type Unspecified