Provider Demographics
NPI:1376624429
Name:RAST, ROBYNE G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBYNE
Middle Name:G
Last Name:RAST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RUTHERFORD RD
Mailing Address - Street 2:STE 101
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4500
Mailing Address - Country:US
Mailing Address - Phone:717-545-5256
Mailing Address - Fax:717-545-5259
Practice Address - Street 1:1 RUTHERFORD RD
Practice Address - Street 2:STE 101
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4500
Practice Address - Country:US
Practice Address - Phone:717-545-5256
Practice Address - Fax:717-545-5259
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61649207L00000X
PAMD433237207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102248160Medicaid
PA2022760OtherHIGHMARK BLUE SHIELD
FLP00207518OtherRAILROAD MEDICARE
FL15101OtherBLUE CROSS & BLUE SHIELD
PA2022760OtherHIGHMARK BLUE SHIELD
FLP00207518OtherRAILROAD MEDICARE
FL15101OtherBLUE CROSS & BLUE SHIELD
F29118Medicare UPIN