Provider Demographics
NPI:1609938869
Name:ROBBINS, MARK (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:110 FRANCIS ST STE 4B
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5501
Mailing Address - Country:US
Mailing Address - Phone:617-632-8658
Mailing Address - Fax:617-632-7514
Practice Address - Street 1:110 FRANCIS ST STE 4B
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-632-8658
Practice Address - Fax:617-632-7514
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA58642207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA058642OtherTUFTS
MA0014963OtherNHP
MA3179575Medicaid
MAPM636OtherHPHC
MA8440394-002OtherCIGNA
MAJ22045OtherBCBS
MAA28684Medicare PIN
MA3179575Medicaid