Provider Demographics
NPI:1578547899
Name:YURKEVICZ, ROBIN L (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:YURKEVICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-595-2505
Mailing Address - Fax:508-854-0650
Practice Address - Street 1:630 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2038
Practice Address - Country:US
Practice Address - Phone:508-595-2505
Practice Address - Fax:508-854-0650
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0406756OtherEVERCARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
9900267OtherFALLON COMMUNITY HEALTH
042472266OtherONE HEALTH PLAN
1150400OtherFIRST HEALTH
AA7085OtherHARVARD PILGRIM HEALTHCAR
26981OtherCHILDRENS MEDICAL SECURIT
3548184OtherCIGNA HEALTHSOURCE
26981OtherHEALTHY START
784110OtherMVP HEALTH CARE
042472266OtherHEALTHCARE VALUE MANAGEME
7756324OtherAETNA US HEALTHCARE
2040670004OtherCIGNA PAL ID REFERAL
B201961011OtherCIGNA HEALTH PLAN
J12763OtherBLUE CARE ELECT
J12763OtherBLUE SHIELD HMO BLUE
J12763OtherBLUE SHIELD INDEMNITY
784110OtherMVP HEALTH CARE
J12763OtherBLUE CARE ELECT
J12763Medicare ID - Type Unspecified