Provider Demographics
NPI:1124063565
Name:HANOWELL, ROBERT G (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:HANOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:137 W PARKER RD STE B
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4622
Mailing Address - Country:US
Mailing Address - Phone:828-439-6025
Mailing Address - Fax:828-438-8777
Practice Address - Street 1:137B W PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4629
Practice Address - Country:US
Practice Address - Phone:828-437-8282
Practice Address - Fax:828-437-8212
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF68186Medicare UPIN