Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 161223 | MA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 161223 | MA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 161223 | MA |
NPI | 1336181270 |
---|---|
Provider Name | Robert S Warren |
First Address | Danvers, MA 01923-2763 |
Second Address | Danvers, MA 01923-2763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 12/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018239800004 | (05) | PA |
0066867000 | IBC - PC/KHPE (01) | PA |
0182398003 | AMERICHOICE (UHC MA PLAN) (01) | PA |
051947 | HIGHMARK BLUE SHIELD (01) | PA |
080182395 | RRM (01) | PA |
10938422 | CAQH ID# (01) | PA |
1164025 | KEYSTONE MERCY (01) | PA |
17713-MD066169L | HEALTH PARTNERS (01) | PA |
2512098 | AETNA HMO (01) | PA |
4519969 | CIGNA HMO/PPO (01) | PA |
7260205 | AETNA PPO (01) | PA |
9402714 | PHCS (01) | PA |
H20771 | (02) | PA |