Provider Demographics
NPI:1003843202
Name:ROBKE, GREGORY JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JOSEPH
Last Name:ROBKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 RESNIK ROAD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-746-2696
Mailing Address - Fax:508-746-2695
Practice Address - Street 1:45 RESNIK ROAD
Practice Address - Street 2:SUITE 302
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-746-2696
Practice Address - Fax:508-746-2695
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155581207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3195104Medicaid
J21238OtherBCBS
401728OtherTUFTS
694202OtherHPHC
MA3195104Medicaid
401728OtherTUFTS