Provider Demographics
NPI:1871552778
Name:DOLINE, ROBERT M (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:DOLINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:2525 COURT DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2140
Practice Address - Country:US
Practice Address - Phone:704-834-2944
Practice Address - Fax:704-834-2857
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC339902085R0001X
SC215552085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC94313OtherMEDCOST
SCN33990Medicaid
NC4274OtherPARTNERS
NC2161437GOtherMEDICARE PTAN
NC28823OtherBLUE CROSS
NC6790876010OtherCIGNA
NC8928823Medicaid
1218228OtherUNITED HEALTHCARE
NC94313OtherMEDCOST
NC4274OtherPARTNERS
SCN33990Medicaid
1218228OtherUNITED HEALTHCARE
NC2161437FMedicare ID - Type UnspecifiedLAKE NORMAN RAD ONC CTR
NC2161437EMedicare ID - Type UnspecifiedMATTHEWS RAD ONC CTR
SCE904516058Medicare ID - Type UnspecifiedSC MEDICARE