Provider Demographics
NPI:1093776957
Name:HARIZI, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:HARIZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-368-3130
Mailing Address - Fax:508-368-3133
Practice Address - Street 1:123 SUMMER STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-368-3130
Practice Address - Fax:508-368-3133
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50299207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherONE HEALTH PLAN
J02282OtherBLUE SHIELD HMO BLUE
28900OtherHEALTHY START
MA6172326Medicaid
J02282OtherBLUE CARE ELECT
042472266OtherHEALTHCARE VALUE MGMT
28900OtherCHILDRENS MED SEC PLAN
060044343OtherRAILROAD MEDICARE
2500244OtherEVERCARE
9900228OtherFALLON COMMUNITY HEALTH P
J02282OtherMEDICARE B
042472266OtherPRIVATE HEALTHCARE SYSTEM
1060727OtherFIRST HEALTH
784026OtherMVP HEALTH CARE
AA3711OtherHARVARD PILGRIM HEALTHCAR
3959664OtherCIGNA HEALTH PLAN
5203224OtherAETNA US HEALTHCARE
J02282OtherBLUE SHIELD INDEMNITY
1060727OtherFIRST HEALTH
MAJ02282Medicare ID - Type Unspecified