Basic Information
| Provider Information | |||||||||
| NPI: | 1427006436 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEADE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | LAWTON | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 602373 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282602373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285261280 | ||||||||
| FaxNumber: | 8285261285 | ||||||||
| Practice Location | |||||||||
| Address1: | 190 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | HIGHLANDS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287417600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285261200 | ||||||||
| FaxNumber: | 8285261230 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 09/15/2016 | ||||||||
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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 | ME48853 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 2013-00725 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 2013-00725 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 14194 | 01 | FL | BCBS | OTHER | P01447966 | 01 | NC | RAILROAD MEDICARE | OTHER | 329964944A | 05 | GA | MEDICAID | NCM488A194 | 01 | NC | MEDICARE PTAN | OTHER | 372067500 | 05 | FL | MEDICAID |