Provider Demographics
NPI:1437198298
Name:CHERREY, ROBERT MARTIN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARTIN
Last Name:CHERREY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 EASTON RD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2852
Mailing Address - Country:US
Mailing Address - Phone:215-491-4665
Mailing Address - Fax:215-491-4602
Practice Address - Street 1:1432 EASTON RD
Practice Address - Street 2:SUITE 2E
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2852
Practice Address - Country:US
Practice Address - Phone:215-491-4665
Practice Address - Fax:215-491-4602
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005111L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0778503000OtherIBC HMO INDIVIDUAL ID
PA5823086OtherAETNA INDIVIDUAL ID
PA2016669002OtherIBC HMO GROUP ID
PA0015725670007Medicaid
PA1050233OtherKEYSTONE MERCY ID
PA2678682OtherAETNA GROUP ID
PA0015725670007Medicaid
PAE70454Medicare UPIN
PA2678682OtherAETNA GROUP ID