Basic Information
Provider Information
NPI: 1720348477
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARDWELL
FirstName: ROBIN
MiddleName: B.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 32861
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282322861
CountryCode: US
TelephoneNumber: 7043553153
FaxNumber: 7043551941
Practice Location
Address1: 910 ADAMS ST SE
Address2: SUITE 200
City: HUNTSVILLE
State: AL
PostalCode: 358013730
CountryCode: US
TelephoneNumber: 2562656512
FaxNumber: 2562656727
Other Information
ProviderEnumerationDate: 05/29/2012
LastUpdateDate: 04/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X35128ALY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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