Provider Demographics
NPI:1417078569
Name:MCINTIRE, K. ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:K. ROBERT
Middle Name:
Last Name:MCINTIRE
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 1:150 MILL RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2624
Mailing Address - Country:US
Mailing Address - Phone:508-477-7090
Mailing Address - Fax:
Practice Address - Street 1:CAPE COD FREE CLINIC
Practice Address - Street 2:19 STEEPLE STREET
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649
Practice Address - Country:US
Practice Address - Phone:508-477-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50646207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology