Provider Demographics
NPI:1619950417
Name:MULTARI, ROBERT D (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:MULTARI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-704-7386
Mailing Address - Fax:724-704-7390
Practice Address - Street 1:2120 LIKENS LN
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-2304
Practice Address - Country:US
Practice Address - Phone:724-981-2246
Practice Address - Fax:724-981-0553
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003730L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007408680005Medicaid
PA0007408680007Medicaid
PA130815RNOMedicare ID - Type Unspecified
PA130815PVDMedicare PIN
PAB36532Medicare UPIN