Healthcare Provider Details

I. General information

NPI: 1528035698
Provider Name (Legal Business Name): ROBERT LAWRENCE MAGRUDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 WHITE OWL LN
CASHIERS NC
28717-4514
US

IV. Provider business mailing address

190 HOSPITAL DR
HIGHLANDS NC
28741-7600
US

V. Phone/Fax

Practice location:
  • Phone: 828-743-2491
  • Fax:
Mailing address:
  • Phone: 828-526-1284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG5325
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: