Provider Demographics
NPI:1407892540
Name:NOONE, ROBERT BARRETT SR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BARRETT
Last Name:NOONE
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:888 GLENBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2506
Mailing Address - Country:US
Mailing Address - Phone:610-527-4833
Mailing Address - Fax:610-527-3568
Practice Address - Street 1:888 GLENBROOK AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2506
Practice Address - Country:US
Practice Address - Phone:610-527-4833
Practice Address - Fax:610-527-3568
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029517L2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA017222FCVMedicare ID - Type Unspecified
PAB32874Medicare UPIN