Dodge, Robert Thomas

Dodge, Robert Thomas is an sole proprietor health care provider with primary practice located at 10 Sunnybrook Rd Clinic A, Raleigh NC 27610-1808. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Dodge, Robert Thomas can be contacted via phone (919) 250-3078.

Contact Information

Primary practice address
10 Sunnybrook Rd Clinic A Raleigh NC 27610-1808
Fax: (919) 250-4429
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 900106 North Carolina

Profile Details

NPI number 1295721710
LBN Legal business name Dodge, Robert Thomas
Credentials PHD, RN, ANP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2005
Last updated Jun 30th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295721710 NPPES
North Carolina MEDICAID 7000428

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