Basic Information
| Provider Information | |||||||||
| NPI: | 1336199769 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHALLER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | NEAL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N ELM ST | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274011004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368327000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 940 GOLF HOUSE CT E | ||||||||
| Address2: | |||||||||
| City: | WHITSETT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273779296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3364499848 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 12/05/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 36819 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5480170 | 01 | NC | AETNA | OTHER | 8976624 | 05 | NC | MEDICAID | 65133 | 01 | NC | MEDCOST | OTHER | 4550 | 01 | NC | PARTNERS MEDICARE | OTHER | 76624 | 01 | NC | BCBS NC | OTHER |