Provider Demographics
NPI:1306831482
Name:WOLD, ROBERT E (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:WOLD
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 1:6 RIVERVIEW PLZ
Mailing Address - Street 2:P O BOX 476
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1863
Mailing Address - Country:US
Mailing Address - Phone:732-747-1429
Mailing Address - Fax:732-747-4778
Practice Address - Street 1:6 RIVERVIEW PLZ
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1863
Practice Address - Country:US
Practice Address - Phone:732-747-1429
Practice Address - Fax:732-747-4778
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA057638002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1121365OtherUNITED HEALTHCARE
NJP00053554OtherRR MEDICARE
NJ0563579000OtherAMERIHEALTH
NJ1045332OtherHORZION MERCY
NJ4099589OtherGHI
NJ0004270629OtherAETNA POS
NJ0733751OtherAETNA HMO
NJ0881356-013OtherCIGNA
NJ658T71OtherWELLCHOICE
NJ22683OtherAMERIGROUP
NJ245855OtherUSA MANAGED CARE
NJ3628726OtherAETNA HMO
NJ5179505Medicaid
NJ245855OtherUSA MANAGED CARE
NJ5179505Medicaid