Provider Demographics
NPI:1336199769
Name:SCHALLER, ROBERT NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEAL
Last Name:SCHALLER
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 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-7000
Mailing Address - Fax:
Practice Address - Street 1:940 GOLF HOUSE CT E
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-9296
Practice Address - Country:US
Practice Address - Phone:336-449-9848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5480170OtherAETNA
NC8976624Medicaid
NC65133OtherMEDCOST
NC4550OtherPARTNERS MEDICARE
NC76624OtherBCBS NC
NC2185040GMedicare ID - Type UnspecifiedMEDICARE
F54171Medicare UPIN