Provider Demographics
NPI:1942255823
Name:MATHES, ROBERT JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:MATHES
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:P O BOX 912
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-0912
Mailing Address - Country:US
Mailing Address - Phone:603-569-7500
Mailing Address - Fax:603-515-2031
Practice Address - Street 1:240 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4411
Practice Address - Country:US
Practice Address - Phone:603-569-7500
Practice Address - Fax:603-515-2031
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7792207Q00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0101168YPNH02OtherANTHEM PROVIDER NUMBER
NH3223706OtherCIGNA PROVIDER NUMBER
NH30201550Medicaid
NH3223706OtherCIGNA PROVIDER NUMBER
NHNH9689Medicare ID - Type Unspecified