Provider Demographics
NPI:1336120377
Name:VANDERLIN, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:VANDERLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:75 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-9147
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:781-871-7418
Practice Address - Street 1:51 PERFORMANCE DR
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3104
Practice Address - Country:US
Practice Address - Phone:781-682-8000
Practice Address - Fax:781-335-1412
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49353207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042297845OtherPRIVATE HEALTHCARE SYSTEM
MA042297845OtherUHC
MA136225OtherHVD PILGRIM HEALTH CARE
MA6181872Medicaid
MA042297845OtherUNITED HEALTH CARE
MA049353OtherTUFTS
MA042297845OtherHCVM
MA042297845OtherDOC FIRST
MA042297845OtherTRICARE
MA34726OtherFALLON
MA4218639OtherAETNA
MA042297845OtherGIC UNICARE
MA042297845OtherGREAT WEST HEALTH CARE
MAJ03518OtherBCBS
MA6181872OtherNEIGHBORHOOD HLTH PLAN
MA702028OtherTUFTS MEDICARE PREFERRED
MAB2082201OtherCIGNA
MA042297845OtherDOC FIRST
MA042297845OtherUNITED HEALTH CARE