Provider Demographics
NPI:1487620183
Name:PATE, ROBERT MARK (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:PATE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1041 NOELL LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2058
Mailing Address - Country:US
Mailing Address - Phone:252-937-8262
Mailing Address - Fax:252-937-8262
Practice Address - Street 1:1041 NOELL LN
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2058
Practice Address - Country:US
Practice Address - Phone:252-937-8262
Practice Address - Fax:252-937-8262
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9600673208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC22673OtherCIGNA
NC8965837Medicaid
NC4525491OtherUNITED HEALTHCARE
NC65837OtherBCBS
NC2222532Medicare ID - Type Unspecified
NC8965837Medicaid