Provider Demographics
NPI:1962486266
Name:SWEENEY, ROBERT MUROL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MUROL
Last Name:SWEENEY
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 1:328 N MICHIGAN ST
Mailing Address - Street 2:STE. 200
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1244
Mailing Address - Country:US
Mailing Address - Phone:574-647-1845
Mailing Address - Fax:574-647-1825
Practice Address - Street 1:100 NAVARRE PL
Practice Address - Street 2:STE. 4440
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1156
Practice Address - Country:US
Practice Address - Phone:574-647-4540
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01019126A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC25541Medicare UPIN