Individual
DR. ROBERT THOMAS DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, RN, ANP
Contact information
Practice address
10 SUNNYBROOK RD, CLINIC A, RALEIGH, NC 27610-1808
(919) 250-3078
(919) 250-4429
Mailing address
10 SUNNYBROOK RD, CLINIC A, RALEIGH, NC 27610-1808
(919) 250-3078
(919) 250-4429
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
900106
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000428
—
NC
Enumeration date
09/20/2005
Last updated
06/30/2010
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