Provider Demographics
NPI:1811942212
Name:CHAO, ROBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:CHAO
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 1:132 W MILLER ST STE C
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-4775
Mailing Address - Country:US
Mailing Address - Phone:336-521-4928
Mailing Address - Fax:336-521-4929
Practice Address - Street 1:132 W MILLER ST STE C
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4775
Practice Address - Country:US
Practice Address - Phone:336-521-4928
Practice Address - Fax:336-521-4929
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200335208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2001212COtherPSC MEDICARE PROVIDER #
NC89131JVMedicaid
NC2001212DMedicare PIN
NC2001212Medicare PIN
NC2001212COtherPSC MEDICARE PROVIDER #
NC2001212AMedicare PIN
NCF33258Medicare UPIN