Provider Demographics
NPI:1629025093
Name:MCEVOY, ROBERT FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANCIS
Last Name:MCEVOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-2615
Mailing Address - Country:US
Mailing Address - Phone:610-588-8282
Mailing Address - Fax:610-588-5161
Practice Address - Street 1:125 S 1ST ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-2615
Practice Address - Country:US
Practice Address - Phone:610-588-8282
Practice Address - Fax:610-588-5161
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020627-E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031214970001Medicaid
PAC29657Medicare UPIN
PA093329KHDMedicare PIN