Provider Demographics
NPI:1558350660
Name:ROBERTS, DAVID HILLEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HILLEL
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:KSB23, BIDMC PULMONARY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-5864
Mailing Address - Fax:617-667-4849
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:KSB23, BIDMC PULMONARY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-5864
Practice Address - Fax:617-667-4849
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2011-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA152595207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0137910Medicaid
MA0137910Medicaid
MAH41488Medicare UPIN