Provider Demographics
NPI:1265492102
Name:THUM, ROBERT G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:THUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:466 OLD HOOK RD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1396
Mailing Address - Country:US
Mailing Address - Phone:201-261-0821
Mailing Address - Fax:201-261-0823
Practice Address - Street 1:466 OLD HOOK RD
Practice Address - Street 2:SUITE 26
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1396
Practice Address - Country:US
Practice Address - Phone:201-261-0821
Practice Address - Fax:201-261-0823
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA047793207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0284106Medicaid
NJ4093545OtherAETNA PRIMARY PPO PIN #
NJ0K2224OtherHEALTHNET PRIMARY PIN #
NJ69D691OtherEMPIRE BCBS PRIMARY PIN #
NH0254989002OtherCIGNA PRIMARY PIN #
NJ2828OtherAETNA SPECIALIST HMO PIN
NJBP466OtherOXFORD PRIMARY PIN #
NJ11546OtherAETNA PRIMARY HMO PIN #
NJ5713271OtherGHI PRIMARY PIN #
NJ2228409630OtherBCBS PRIMARY PIN #
NJ5713271OtherGHI PRIMARY PIN #
NJ196368BT2Medicare ID - Type Unspecified