Provider Demographics
NPI:1255376786
Name:MCALISTER MANGIONE, ROBIN JEAN (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:JEAN
Last Name:MCALISTER MANGIONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:MCALISTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2920 HIGHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-0010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 ASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6130
Practice Address - Country:US
Practice Address - Phone:919-859-1136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7949207PE0004X
ORMD192324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1255376786Medicaid
OK100072580AMedicaid
AR119187001Medicaid
OK100072580AMedicaid
AR54456G180Medicare PIN