Individual
ROBERT JOSEPH OPTICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25706
TN
2085R0202X
Diagnostic Radiology Physician
Primary
35243
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115965
—
MS
05
—
125862001
—
AR
05
—
207692708
—
MO
01
—
3029527
BCBS
TN
05
—
3085061
—
TN
01
—
96941
BCBS
AR
Enumeration date
09/07/2006
Last updated
01/06/2023
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