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NPI Code Detail

MEDICARE: DR. ROBERT J. ANDERSON PH.D.

MEDICARE: DR. ROBERT J. ANDERSON PH.D.
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
1103TC0700XClinical Psychologist1891NC
2103T00000XPsychologist

General Provider Information

NPI Number : 1912992777
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT J. ANDERSON PH.D.
Provider Business Mailing Address
First Line : PO BOX 538622
Second Line :
City : ATLANTA
State : GA
Zip : 30353-8622
Country : US
Telephone Number : 910-794-4521
Fax Number : 877-364-7056
Provider Business Practice Location Address
First Line : 3205 RANDALL PKWY STE 105
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-2565
Country : US
Telephone Number : 910-742-9243
Fax Number : 888-746-1787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2005
Last Update Date : 12/27/2019

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