Provider Demographics
NPI:1346544764
Name:DICHIERA, ROBERT C (PA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:DICHIERA
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5056 NC HIGHWAY 43 S
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8357
Mailing Address - Country:US
Mailing Address - Phone:719-237-2530
Mailing Address - Fax:
Practice Address - Street 1:598 W OLD COUNTY RD
Practice Address - Street 2:
Practice Address - City:BELHAVEN
Practice Address - State:NC
Practice Address - Zip Code:27810-1232
Practice Address - Country:US
Practice Address - Phone:252-943-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-14260363A00000X
GA008687363A00000X
TX1092269363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant