FRED SHAUNE ROBERTSON M.D. NPI 1235238106

NPI Information

  • NPI: 1235238106
  • Provider Name: FRED SHAUNE ROBERTSON, M.D.
  • Classification: Emergency Medicine - 207PE0004X
  • Specialization: Emergency Medical Services
  • Entity Type: Individual
  • Address: 800 WHEELING AVE
    GLEN DALE, WV
    ZIP 26038
  • Phone: (304) 845-3211

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NPI Details

Fred Shaune Robertson, M.D. is an emergency medical services emergency medicine in Glen Dale, WV. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. Fred Shaune Robertson, M.D. NPI is 1235238106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

800 WHEELING AVE
GLEN DALE, WV
ZIP 26038-660
Phone: (304) 845-3211
Fax: (304) 843-3202

The enumeration date for this NPI number is 9/21/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207PE0004XEmergency MedicineEmergency Medical Services19254WEST VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E64284MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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