Provider Demographics
NPI:1831274992
Name:ARMADA, ROBERT ALEJO (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALEJO
Last Name:ARMADA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:901-227-3255
Mailing Address - Fax:
Practice Address - Street 1:1312 BISHOP ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5406
Practice Address - Country:US
Practice Address - Phone:731-885-5100
Practice Address - Fax:731-885-7584
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3794207V00000X
CA020A47600207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE08814Medicare UPIN
CABM197ZMedicare PIN
CA020A47600Medicare PIN
E08814Medicare UPIN