Individual
ROBERT ELLIS MCINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 WATERFIELD DR, GARNER, NC 27529
(919) 800-4400
(919) 573-4163
Mailing address
2050 MERCANTILE DR, LELAND, NC 28451-4053
(910) 371-2500
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2015-01804
NC
2084P0804X
Child & Adolescent Psychiatry Physician
45105
WI
2084P0804X
Child & Adolescent Psychiatry Physician
G88381
CA
2084P0804X
Child & Adolescent Psychiatry Physician
ME105882
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001782300
—
FL
05
—
34296500
—
WI
01
—
CA116295
SANTA CRUZ COUNTY MEDICARE PTAN#
CA
01
—
CA116296
SANTA CRUZ COUNTY MEDICARE PTAN#
CA
01
—
CA116297
SANTA CRUZ COUNTY MEDICARE PTAN#
CA
01
—
FHC 70042
COUNTY OF SANTA CRUZ MEDI-CAL GROUP#
CA
01
—
FHC 70044F
COUNTY OF SANTA CRUZ MEDI-CAL GROUP#
CA
01
—
ZZZ91891Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
01
—
ZZZ91892Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
01
—
ZZZ92069Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
Enumeration date
09/21/2006
Last updated
02/19/2019
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