Provider Demographics
NPI:1073503751
Name:NAHILL, ROBERT G (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:NAHILL
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 1:116 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-3808
Mailing Address - Country:US
Mailing Address - Phone:508-747-1318
Mailing Address - Fax:508-747-1410
Practice Address - Street 1:116 COURT ST STE 1
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-8710
Practice Address - Country:US
Practice Address - Phone:508-747-1318
Practice Address - Fax:508-747-1410
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA36111207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2066793Medicaid
MAA35352Medicare UPIN
MA2066793Medicaid