Provider Demographics
NPI:1326194648
Name:CHILDS, ROBERT WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:CHILDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PEDIATRIC ASSOCIATES OF HAZLETON
Mailing Address - Street 2:1000 ALLIANCE DRIVE
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-3234
Mailing Address - Country:US
Mailing Address - Phone:570-501-6400
Mailing Address - Fax:570-453-2353
Practice Address - Street 1:LEHIGH VALLEY PHYSICIAN BUSINESS SERVICES
Practice Address - Street 2:1650 VALLEY CENTER PARKWAY, SUITE 100
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-3234
Practice Address - Country:US
Practice Address - Phone:484-884-4436
Practice Address - Fax:484-884-7367
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-014506-E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005875560006Medicaid
PA170494OtherBLU CROSS BLUE SHIELD
PA558825OtherAETNA
PA12004OtherGEISINGER HEALTH PLAN
PA003004OtherFIRST PRIORITY HEALTH
PAP3287365OtherOXFORD
PA81001OtherUNISON
PA0005875560006Medicaid