Provider Demographics
NPI:1720032667
Name:LINDEMAN, ROBERT PHILIP (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PHILIP
Last Name:LINDEMAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 UNION ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-7700
Mailing Address - Country:US
Mailing Address - Phone:508-655-9699
Mailing Address - Fax:
Practice Address - Street 1:67 UNION ST
Practice Address - Street 2:SUITE 305
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:508-655-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204186208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1020621OtherUHC PROVIDER ID
MA202224OtherHPHC PROVIDER ID
MA9720260Medicaid
MA204186OtherTUFTS PROVIDER ID
MA2316135OtherAETNA PROVIDER ID
MA3207595Medicaid
MAJ22214OtherBCBS PROVIDER ID
MA3207595Medicaid