Provider Demographics
NPI:1629024849
Name:OWNBEY, ROBERT T (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:OWNBEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:245 N 15TH ST
Practice Address - Street 2:MS 435
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1101
Practice Address - Country:US
Practice Address - Phone:215-762-8873
Practice Address - Fax:215-762-3274
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2016-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD074365L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001870012Medicaid
PA001870012Medicaid