Provider Demographics
NPI:1588698567
Name:ROBINSON, WANDA SPOLNICKI (MD)
Entity type:Individual
Prefix:DR
First Name:WANDA
Middle Name:SPOLNICKI
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:SPOLNICKI
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5960 FAIRVIEW RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3113
Mailing Address - Country:US
Mailing Address - Phone:704-495-6334
Mailing Address - Fax:704-817-7219
Practice Address - Street 1:201 S COLLEGE ST FL 12
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28244
Practice Address - Country:US
Practice Address - Phone:704-489-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047074207R00000X
NC36601207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1588698567Medicaid
110229707OtherMCR RR
NC78972OtherBCBS NC
SCN36601Medicaid
NC8978972Medicaid
NC2186489HMedicare PIN
NC2186489JMedicare PIN
NC78972OtherBCBS NC
110229707OtherMCR RR
SCN36601Medicaid