Provider Demographics
NPI:1477519031
Name:YAGER, ROBERT DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DOUGLAS
Last Name:YAGER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:C/O ST MARY'S HEALTH SYSTEM - PROVIDER ENROLLMENT
Mailing Address - Street 2:PO BOX 7291
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8695
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:39 SIMON ST
Practice Address - Street 2:UNIT 6
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3046
Practice Address - Country:US
Practice Address - Phone:603-595-2300
Practice Address - Fax:603-889-1333
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2021-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH6752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3087098Medicaid
P00817917OtherRAILROAD MEDICARE PTAN
NHNX0392OtherPTAN
01YP04244NH01OtherANTHEM BCBS
NH30209464Medicaid
C66064Medicare UPIN