Provider Demographics
NPI:1932547866
Name:NULL, ROBERT CHRISTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHRISTIAN
Last Name:NULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4801 S CLIFF AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6954
Mailing Address - Country:US
Mailing Address - Phone:816-478-1230
Mailing Address - Fax:816-350-4585
Practice Address - Street 1:4741 S COCHISE DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055
Practice Address - Country:US
Practice Address - Phone:816-478-1230
Practice Address - Fax:816-478-4413
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019017090207W00000X, 207WX0009X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist