Provider Demographics
NPI:1598734188
Name:LEITCH, ROBERT R (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:LEITCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:235 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01373-9790
Mailing Address - Country:US
Mailing Address - Phone:413-665-2099
Mailing Address - Fax:413-665-5189
Practice Address - Street 1:235 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTH DEERFIELD
Practice Address - State:MA
Practice Address - Zip Code:01373-9790
Practice Address - Country:US
Practice Address - Phone:413-665-2099
Practice Address - Fax:413-665-5189
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA37073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-3194547OtherPIONEER PPO
MA000000031613OtherBMC
MA04-3194547OtherCONSOLIDATED
MA04-3194547OtherTRICARE/CHAMPUS
MA037073OtherCONNECTICARE
MA04-3194547OtherNORTH AMERICAN PREFERRED
MD04-3194547OtherPLAN VISTA
MD20589OtherHEALTH NEW ENGLAND
MA6189253Medicaid
MA66562OtherHARVARD PILGRIM
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA04-3194547OtherPRIVATE HEALTHCARE SYSTEM
MA6433313OtherCIGNA
MA2517704OtherAETNA
MAJ04648OtherBCBSMA
MA04-3194547OtherGREAT-WEST
MA37073OtherTUFTS
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA37073OtherTUFTS