Provider Demographics
NPI:1194740647
Name:KASTNER, ROBERT JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEFFREY
Last Name:KASTNER
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 1:8811 SAWMILL CREEK LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8353
Mailing Address - Country:US
Mailing Address - Phone:910-547-1910
Mailing Address - Fax:
Practice Address - Street 1:311 S CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425-5011
Practice Address - Country:US
Practice Address - Phone:910-799-1810
Practice Address - Fax:910-452-2571
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCG333AOtherPTAN
E70308Medicare UPIN