Provider Demographics
NPI:1437163672
Name:SAUL, ROBERT EUGENE (RCS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EUGENE
Last Name:SAUL
Suffix:
Gender:M
Credentials:RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 508
Mailing Address - Street 2:
Mailing Address - City:AVIS
Mailing Address - State:PA
Mailing Address - Zip Code:17721-0508
Mailing Address - Country:US
Mailing Address - Phone:570-769-1651
Mailing Address - Fax:570-769-6431
Practice Address - Street 1:930 BELLEFONTE AVE
Practice Address - Street 2:NWD PLAZA, SUITE 105
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2754
Practice Address - Country:US
Practice Address - Phone:570-748-7072
Practice Address - Fax:570-748-7084
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NAT'L REG # 00000545246W00000X, 246X00000X, 246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
No246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2109347OtherAETNA
PA220984OtherHEALTH AMERICA/COVENTRY
PA07021094Medicaid
PA020726Medicare ID - Type Unspecified