Matlack, Robert K

Matlack, Robert K is an sole proprietor health care provider with primary practice located at 2587 Ravenhill Dr , Fayetteville NC 28303-5451. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Matlack, Robert K can be contacted via phone (910) 323-1543.

Contact Information

Primary practice address
2587 Ravenhill Dr Fayetteville NC 28303-5451
Phone: (910) 323-1543
Fax: (910) 485-1257
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 200201282 North Carolina
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 20021282 North Carolina

Profile Details

NPI number 1700881190
LBN Legal business name Matlack, Robert K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2005
Last updated Nov 16th, 2009 - 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 1700881190 NPPES
North Carolina Other 301980 MANAGED HEALTH NETWORK
North Carolina Other 7448603 MANAGED HEALTH NETWORK
North Carolina Other 2123955 MANAGED HEALTH NETWORK
North Carolina MEDICAID 891327F MANAGED HEALTH NETWORK
North Carolina Other 1327F MANAGED HEALTH NETWORK

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