Provider Demographics
NPI:1427148717
Name:RAPER, ROBERT MICHAEL
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MICHAEL
Last Name:RAPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MOSSBURG DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-9039
Mailing Address - Country:US
Mailing Address - Phone:919-731-3802
Mailing Address - Fax:919-735-6309
Practice Address - Street 1:2303 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1725
Practice Address - Country:US
Practice Address - Phone:919-734-0741
Practice Address - Fax:919-735-6309
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist