Provider Demographics
NPI:1750364535
Name:MCCUNNEY, ROBERT JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:MCCUNNEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:COX 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-1721
Practice Address - Fax:617-724-9948
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2015-04-30
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Provider Licenses
StateLicense IDTaxonomies
MA445772083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0105651Medicaid
MAE05707OtherBCBS MA
MA044577OtherTUFTS HEALTH PLAN
MAE05707Medicare ID - Type Unspecified
D75147Medicare UPIN