Provider Demographics
NPI:1740504067
Name:CHERNOFF, ROBERT WESLEY (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WESLEY
Last Name:CHERNOFF
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 1:1004 BROADMOOR RD.
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1934
Mailing Address - Country:US
Mailing Address - Phone:610-527-3536
Mailing Address - Fax:
Practice Address - Street 1:1004 BROADMOOR RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1934
Practice Address - Country:US
Practice Address - Phone:610-527-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PWMD005844E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine