Healthcare Provider Details

I. General information

NPI: 1962467944
Provider Name (Legal Business Name): ROBERT ALEXANDER CERWIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 BROWNING PL
RALEIGH NC
27609-6504
US

IV. Provider business mailing address

PO BOX 19368
RALEIGH NC
27619-9368
US

V. Phone/Fax

Practice location:
  • Phone: 919-787-8221
  • Fax: 919-789-4461
Mailing address:
  • Phone: 919-787-8221
  • Fax: 919-789-4461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20709
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: