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General NPI Number Information
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NPI Number | 1629168331
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Entity Type | Individual
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Provider Name | ROBERT GOLDBACH MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 100 S 10TH ST STE B
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City | LILLINGTON
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State | NC
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Zip | 27546-6690
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Country | US
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Telephone | 910-984-8229
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Fax | 910-514-9717
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Provider Business Mailing Address
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Address Line | PO BOX 647
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City | HOPE MILLS
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State | NC
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Zip | 28348-0647
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Country | US
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Telephone | 910-483-7337
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Fax | 910-483-0648
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 9400254
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License Number State | NC
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