Individual
DR. ROBERT LAKE CONDER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1540 SUNDAY DR, SUITE 200, RALEIGH, NC 27607-6000
(919) 859-9040
(919) 859-9030
Mailing address
1540 SUNDAY DR, SUITE 200, RALEIGH, NC 27607-6000
(919) 859-9040
(919) 859-9030
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1397
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0324F
BLUE CROSS
NC
05
—
6000627
—
NC
Enumeration date
09/19/2006
Last updated
07/09/2007
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