Healthcare Provider Details

I. General information

NPI: 1902269293
Provider Name (Legal Business Name): ROBERT MATTHEW WHAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 TURTLE CREEK DR
ASHEVILLE NC
28803-3152
US

IV. Provider business mailing address

21 TURTLE CREEK DR
ASHEVILLE NC
28803-3152
US

V. Phone/Fax

Practice location:
  • Phone: 828-692-4356
  • Fax: 828-697-0148
Mailing address:
  • Phone: 828-692-4356
  • Fax: 828-697-0148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number008703
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number286841
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number286841
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number2022-02637
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: