Provider Demographics
NPI:1013910116
Name:AMORY, ROBERT M (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:AMORY
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 1:16761 S. PARK CENTER
Mailing Address - Street 2:CLEVELAND CLINIC, STRONGSVILLE FAMILY HEALTH CENTER
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136
Mailing Address - Country:US
Mailing Address - Phone:440-878-2500
Mailing Address - Fax:440-878-3003
Practice Address - Street 1:16761 SOUTHPARK CTR
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-9302
Practice Address - Country:US
Practice Address - Phone:440-878-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.013129207RC0000X
PAOS007397L207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDF4147OtherRR MEDICARE
SC060055853OtherRR MEDICARE
PA1025508250001Medicaid
SCG25691Medicare UPIN
PA207954Medicare PIN