Provider Demographics
NPI:1134144421
Name:QUINN, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:QUINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-0749
Mailing Address - Country:US
Mailing Address - Phone:802-851-8619
Mailing Address - Fax:802-851-8716
Practice Address - Street 1:1878 MOUNTAIN RD STE 3
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4775
Practice Address - Country:US
Practice Address - Phone:802-253-4853
Practice Address - Fax:802-888-1759
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA226701207Q00000X
VT042.0010997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-2161484OtherGREAT-WEST
MA04-2161484OtherPLAN VISTA
MA04-2161484OtherCONSOLIDATED
VT1011712Medicaid
MA1302469Medicaid
MAJ29739OtherBCBS MA
MA0037148OtherNEIGHORHOOD HEALTH
MA04-2161484OtherNORTHEAST HEALTH DIRECT
MA7212746OtherAETNA
MA04-2161484OtherPHCS
MA37785OtherHEALTH NEW ENGLAND
MA486940OtherTUFTS
MAAA51427OtherHARVARD PILGRIM
MA04-2161484OtherNORTHEAST HEALTHCARE ALLI
MA226701OtherCONNECTICARE
MA04-2161484OtherUNICARE/GIC
MA000000033487OtherBMC
MA04-2161484OtherNORTH AMERICAN PREFERRED
MA1458784OtherCIGNA
MA04-2161484OtherUNICARE/GIC