Provider Demographics
NPI:1720101629
Name:TEPPER, ROBERT IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:IRA
Last Name:TEPPER
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 1:53 LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1610
Mailing Address - Country:US
Mailing Address - Phone:617-921-7042
Mailing Address - Fax:
Practice Address - Street 1:53 LAUREL RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1610
Practice Address - Country:US
Practice Address - Phone:617-921-7042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50875207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology