Provider Demographics
NPI:1144223371
Name:PURSELL, ROBERT N (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:N
Last Name:PURSELL
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 1:701 OSTRUM ST
Mailing Address - Street 2:SUITE 602
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1152
Mailing Address - Country:US
Mailing Address - Phone:610-865-5888
Mailing Address - Fax:610-865-1697
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 602
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1152
Practice Address - Country:US
Practice Address - Phone:610-865-5888
Practice Address - Fax:610-865-1697
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036441L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000085892OtherUNISON HEALTH PLAN
1521236OtherGATEWAY HEALTH PLAN
PA0006528230001Medicaid
0000155375503OtherUNITED HEALTHCARE
01221001OtherCAPITAL BLUE CROSS
20008806OtherAMERIHEALTH MERCY HEALTH
NJ2349701Medicaid
39566OtherGEISINGER HEALTH PLAN
000081276OtherHIGHMARK BLUE SHIELD
20008806OtherAMERIHEALTH MERCY HEALTH
0000155375503OtherUNITED HEALTHCARE
1521236OtherGATEWAY HEALTH PLAN
PA0006528230001Medicaid