Provider Demographics
NPI:1790863397
Name:ASTAPOVEH, ROBERT W (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:ASTAPOVEH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16 CLARKE ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4988
Mailing Address - Country:US
Mailing Address - Phone:781-861-8499
Mailing Address - Fax:781-861-8507
Practice Address - Street 1:16 CLARKE ST
Practice Address - Street 2:SUITE 12
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4988
Practice Address - Country:US
Practice Address - Phone:781-861-8499
Practice Address - Fax:781-861-8507
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1612786Medicaid
MA32679OtherFALLON
MA350160OtherHARVARD PILGRIM
MAP2506294OtherOXFORD HEALTH PLAN
MA775304OtherTUFTS HEALTH PLAN
MAB20422301OtherCIGNA
MA2163515OtherAETNA
MAY36457OtherBCBS
MA44-00198OtherUNITED HEALTH CARE
MA613974OtherACN
MA0017712OtherNEIGHBORHOOD HEALTH PLAN
MAB20422301OtherCIGNA
MA1612786Medicaid