Provider Demographics
NPI:1073625356
Name:MCARDLE, ROBERT D (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:MCARDLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7291
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-755-3781
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:93 CAMPUS AVE STE G025
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-777-4320
Practice Address - Fax:207-777-4331
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO1294207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1073625356Medicaid
ME5171271OtherAETNA
MEE27447OtherHARVARD PILGRIM
ME1836395OtherCIGNA
ME1073625356OtherANTHEM
ME5171271OtherAETNA
ME1073625356Medicaid