Healthcare Provider Details

I. General information

NPI: 1588674162
Provider Name (Legal Business Name): ROBERT JOSEPH UHREN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 OLD HWY 70 SUITE A
BLK MTN NC
28711
US

IV. Provider business mailing address

997 OLD HWY 70 SUITE A
BLK MTN NC
28711
US

V. Phone/Fax

Practice location:
  • Phone: 828-669-9704
  • Fax: 828-669-7413
Mailing address:
  • Phone: 828-669-9704
  • Fax: 828-669-7413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22191
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: