Provider Demographics
NPI:1104871581
Name:ARYEETEY, ROBERT ADJAMAH (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ADJAMAH
Last Name:ARYEETEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 OLD MOCKSVILLE ROAD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-1951
Mailing Address - Country:US
Mailing Address - Phone:704-878-2523
Mailing Address - Fax:704-878-6417
Practice Address - Street 1:276 OLD MOCKSVILLE ROAD
Practice Address - Street 2:SUITE 1100
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-1951
Practice Address - Country:US
Practice Address - Phone:704-878-2523
Practice Address - Fax:704-878-6417
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-00729207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902405Medicaid
NC2049016Medicare ID - Type Unspecified
NC5902405Medicaid
H55035Medicare UPIN