Provider Demographics
NPI:1811912264
Name:SCHAFERMEYER, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SCHAFERMEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 BLAKENEY PARK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-5703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6025 BLAKENEY PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-5703
Practice Address - Country:US
Practice Address - Phone:704-667-4480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC254212080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC74748OtherBCBS
NC8974748Medicaid
NC930037299/ P00410679OtherRR MC
SCN25421Medicaid
NC1811912264Medicaid
NCNCI956AMedicare PIN
NC930037299/ P00410679OtherRR MC
NCC86323Medicare UPIN
NCNCI956CMedicare PIN
NC210194CMedicare PIN
NCNCI956BMedicare PIN
NC74748OtherBCBS
NCNCI956EMedicare PIN
NC210194DMedicare PIN