Provider Demographics
NPI:1174673289
Name:ROBERT T. FRITZ, M.D. P.C.
Entity Type:Organization
Organization Name:ROBERT T. FRITZ, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-921-0944
Mailing Address - Street 1:PARKHURST MEDICAL BLDG
Mailing Address - Street 2:75 HERRICK ST
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5900
Mailing Address - Country:US
Mailing Address - Phone:978-921-0944
Mailing Address - Fax:978-927-5844
Practice Address - Street 1:PARKHURST MEDICAL BLDG
Practice Address - Street 2:75 HERRICK ST
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5900
Practice Address - Country:US
Practice Address - Phone:978-921-0944
Practice Address - Fax:978-927-5844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9752706Medicaid
MA9752706Medicaid