Provider Demographics
NPI:1710920319
Name:MCCAIRNS, ROBERT G (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:MCCAIRNS
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 1:1300 WOLF ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2912
Mailing Address - Country:US
Mailing Address - Phone:215-551-0360
Mailing Address - Fax:215-551-8725
Practice Address - Street 1:1300 WOLF ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2912
Practice Address - Country:US
Practice Address - Phone:215-551-0360
Practice Address - Fax:215-551-8725
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019517E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000943052 0008Medicaid
NJ8977402Medicaid
PA000943052 0008Medicaid
NJ8977402Medicaid
NJ8977402Medicaid