Provider Demographics
NPI:1497780605
Name:O'REILLY, ROBERT M (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:O'REILLY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:111 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:207-778-4922
Mailing Address - Fax:207-779-0646
Practice Address - Street 1:131 FRANKLIN HEALTH CMNS
Practice Address - Street 2:SUITE F
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6142
Practice Address - Country:US
Practice Address - Phone:207-778-4922
Practice Address - Fax:207-779-0646
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME0747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEB41882Medicare UPIN
MEMM9347Medicare ID - Type Unspecified