Provider Demographics
NPI:1104896232
Name:PERKINS, ROBERT SANDBORN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SANDBORN
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:808 SCHENCK ST
Mailing Address - Street 2:CLECO PRIMARY CARE NETWORK
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3934
Mailing Address - Country:US
Mailing Address - Phone:704-484-3647
Mailing Address - Fax:704-471-2727
Practice Address - Street 1:808 SCHENCK ST
Practice Address - Street 2:CLECO MEDICAL CENTER OF SHELBY
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3934
Practice Address - Country:US
Practice Address - Phone:704-484-3647
Practice Address - Fax:704-471-2727
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC27277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8966816Medicaid
C85949Medicare UPIN
NC209515AMedicare PIN