Provider Demographics
NPI:1245541093
Name:MEADOWS, ROBERT MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MICHAEL
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:PA-C
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:540 GRAND WAILEA DR APT 832
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8202
Mailing Address - Country:US
Mailing Address - Phone:910-818-3563
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:910-818-3563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-27
Last Update Date:2018-04-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant