Provider Demographics
NPI:1396766242
Name:ENGLES, ROBERT E (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:ENGLES
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 E SOUTH BLVD STE 503
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2004
Mailing Address - Country:US
Mailing Address - Phone:334-284-6500
Mailing Address - Fax:334-284-6202
Practice Address - Street 1:2055 E SOUTH BLVD STE 503
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2004
Practice Address - Country:US
Practice Address - Phone:334-284-6500
Practice Address - Fax:334-284-6202
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL161152086S0129X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51032318OtherBLUE CROSS NUMBER
AL000032318Medicaid
ALF84068Medicare UPIN
AL000032318Medicare ID - Type Unspecified