Provider Demographics
NPI:1518958024
Name:WEITZMAN, ROBERT B (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:WEITZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5001
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-5001
Mailing Address - Country:US
Mailing Address - Phone:413-582-2022
Mailing Address - Fax:413-582-2530
Practice Address - Street 1:234 RUSSELL ST
Practice Address - Street 2:SUITE 7
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-3534
Practice Address - Country:US
Practice Address - Phone:413-586-6020
Practice Address - Fax:413-584-0286
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2020-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA60098207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3038408Medicaid
MA000000007922OtherBMC HEALTHNET
MA1024120OtherCIGNA
MA20407OtherHEALTH NEW ENGLAND
MAJ07545OtherMEDICARE LEGACY NUMBER
MA600981OtherCONNECTICARE
MA71793OtherHARVARD PILGRIM HEALTHPLA
MA7280191OtherAETNA
MAJ07545OtherBCBS OF MASSACHUSETTS
MA080116920OtherMEDICARE RAILROAD
MA060098OtherTUFTS
MA7280191OtherAETNA
MA3038408Medicaid