MEDICARE: DR. ROBERT JEFFREY KASTNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	27608	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NCG333A	OTHER	NC	PTAN

General Provider Information

NPI Number	:	1194740647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JEFFREY KASTNER MD

Provider Business Mailing Address
First Line	:	8811 SAWMILL CREEK LN
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-8353
Country	:	US
Telephone Number	:	910-547-1910
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 S CAMPBELL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5011
Country	:	US
Telephone Number	:	910-799-1810
Fax Number	:	910-452-2571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	02/20/2024

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