Provider Demographics
NPI:1174595102
Name:MCCARVER, ROBERT R III (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:MCCARVER
Suffix:III
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 1:12385 SW 125TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5488
Mailing Address - Country:US
Mailing Address - Phone:602-791-7450
Mailing Address - Fax:
Practice Address - Street 1:12385 SW 125TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5488
Practice Address - Country:US
Practice Address - Phone:602-791-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ204252085R0202X
FL1409082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZXPY189349OtherMEDI-CAL MEDICAID
AZ350710Medicaid
AZ1Z7086OtherHEALTH NET OF AZ
AZAZ0221810OtherBCBSAZ
AZZ121397Medicare PIN
AZ350710Medicaid
AZZ121134Medicare PIN
AZXPY189349OtherMEDI-CAL MEDICAID
AZ1Z7086OtherHEALTH NET OF AZ
F21299Medicare UPIN
AZZ30WCHLX1QMedicare PIN
AZZ30WCHQV1QMedicare PIN