Individual
DR. ROBERT PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 343-7597
(910) 815-5489
Mailing address
PO BOX 602172, CHARLOTTE, NC 28260-2172
(910) 343-7597
(910) 815-5489
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2006-01099
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905062
—
NC
05
—
Q0109H
—
SC
Enumeration date
07/26/2006
Last updated
09/20/2011
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