Healthcare Provider Details

I. General information

NPI: 1437105665
Provider Name (Legal Business Name): ROBERT FAULKNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 JUDGES RD STE 4E
WILMINGTON NC
28405-3655
US

IV. Provider business mailing address

311 JUDGES RD STE 4E
WILMINGTON NC
28405-3655
US

V. Phone/Fax

Practice location:
  • Phone: 910-791-6767
  • Fax: 910-399-2190
Mailing address:
  • Phone: 910-791-6767
  • Fax: 910-399-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number201200924
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35040837F
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: