Provider Demographics
NPI:1124048863
Name:ROBINETTE, GEORGE DAVE II (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:DAVE
Last Name:ROBINETTE
Suffix:II
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5427 NC HIGHWAY 49 S
Practice Address - Street 2:STE 105
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7408
Practice Address - Country:US
Practice Address - Phone:704-454-7268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93002992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1124048863Medicaid
NC8972473Medicaid
NC2203117EOtherMEDICARE PTAN, INDIVIDUAL
NC232009OtherMEDICARE PTAN, GROUP
NC2203117EOtherMEDICARE PTAN, INDIVIDUAL
NC8972473Medicaid