Provider Demographics
NPI:1861478034
Name:AUERBACH, ROBERT STEPHEN (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEPHEN
Last Name:AUERBACH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-745-8989
Mailing Address - Fax:215-745-9072
Practice Address - Street 1:7602 CENTRAL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19111-2443
Practice Address - Country:US
Practice Address - Phone:215-745-8989
Practice Address - Fax:215-745-9072
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002949L207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP691140OtherOXFORD
PA0005064OtherAETNA - HMO
PA101468089Medicaid
PA0073489405OtherAMERICHOICE
PA6771OtherBRAVO HEALTH
PA597586OtherMEDICARE GROUP TPI
PA3Y3689OtherHEALTH NET
PA1075764OtherKEYSTONE MERCY HEALTH PLA
PA863236OtherCOVENTRY HEALTH AMERICA
PA0052801000OtherINDEPENDENCE BLUE CROSS
PA160039143OtherRAILROAD MEDICARE
PA4353532OtherAETNA PPO
PACD4829OtherRAILROAD MEDICARE TPI
PA073839OtherHIGHMARK BLUE SHIELD
PA3Y3689OtherHEALTH NET
PA073839Medicare PIN