MEDICARE: ROBERT P SANKOWSKI CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	036361	NC
2	163W00000X	Registered Nurse	083941	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164445318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT P SANKOWSKI CRNA

Provider Business Mailing Address
First Line	:	2430 EMERALD PL
Second Line	:	SUITE 201
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5784
Country	:	US
Telephone Number	:	252-752-2140
Fax Number	:	252-752-8054

Provider Business Practice Location Address
First Line	:	2430 EMERALD PL
Second Line	:	SUITE 201
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5784
Country	:	US
Telephone Number	:	252-752-2140
Fax Number	:	252-752-8054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	09/17/2007

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