MEDICARE: ROBERT A WAHLBRINK MD

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	2085R0202X	Diagnostic Radiology Physician	35057814	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300058752	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000000005553	OTHER	OH	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457359754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A WAHLBRINK MD

Provider Business Mailing Address
First Line	:	1331 N ELM ST
Second Line	:	SUITE 200
City	:	GREENSBORO
State	:	NC
Zip	:	27401-6302
Country	:	US
Telephone Number	:	336-274-9617
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 N WILSON DR
Second Line	:
City	:	WEST UNION
State	:	OH
Zip	:	45693-1577
Country	:	US
Telephone Number	:	937-544-1544
Fax Number	:

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	06/24/2016

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