Provider Demographics
NPI:1790926228
Name:MEEHAN, ROBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:MEEHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:825 CHALKSTONE AVE
Mailing Address - Street 2:MEDICAL EDUCATION
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-4728
Mailing Address - Country:US
Mailing Address - Phone:401-456-2099
Mailing Address - Fax:401-456-6772
Practice Address - Street 1:825 CHALKSTONE AVE
Practice Address - Street 2:MEDICAL EDUCATION
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4728
Practice Address - Country:US
Practice Address - Phone:401-456-2099
Practice Address - Fax:401-456-6772
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD13771207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine