Provider Demographics
NPI:1710945860
Name:DONATO, ROBERT ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALFRED
Last Name:DONATO
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 1:995 S YATES RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0882
Mailing Address - Country:US
Mailing Address - Phone:901-527-7100
Mailing Address - Fax:901-527-7124
Practice Address - Street 1:995 S YATES RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0882
Practice Address - Country:US
Practice Address - Phone:901-527-7100
Practice Address - Fax:901-527-7124
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2010-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36335208800000X
MS17711208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3722370OtherCIGNA
2079595OtherFIRST HEALTH
TN3873632Medicaid
02110026200OtherQUAL CHOICE
660724OtherHEALTH LINK
TN4041786OtherBLUE CROSS
99287OtherBLUE CROSS AR
13305935OtherPHCS
211159OtherSOUTHERN HEALTH SERVICES
7436345OtherAETNA
7436345OtherAETNA
TN340020122Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MS340020121Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MS340000231Medicare ID - Type Unspecified
02110026200OtherQUAL CHOICE