Provider Demographics
NPI:1780613265
Name:BARBUTO, ROBERT W (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:BARBUTO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:52 BERLIN RD
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3574
Mailing Address - Country:US
Mailing Address - Phone:856-795-1003
Mailing Address - Fax:856-795-5994
Practice Address - Street 1:52 BERLIN RD
Practice Address - Street 2:SUITE 5000
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3574
Practice Address - Country:US
Practice Address - Phone:856-795-1003
Practice Address - Fax:856-795-5994
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00101100213E00000X
PASC001621L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0009785OtherGROUP HEALTH INSURANCE
NJ1082520OtherHORIZON INSURANCE
PA0060695000OtherKEYSTONE HEALTH PLAN EAST
NJ14959OtherAMERIGROUP OF NJ
15115OtherUNIVERSITY HEALTH PLAN
NJ1290703Medicaid
F14282OtherHEALTH NET
PA00506066-04OtherAMERICHOICE OF PA
480010991OtherRAILROAD MEDICARE
NJME0000076-00OtherAMERICHOICE OF NJ
NJ0392528000OtherAMERIHEALTH OF NJ
208038000OtherUS DEPT OF LABOR
2314788OtherAETNA
JS202OtherOXFORD INSURANCE
2314788OtherAETNA
0009785OtherGROUP HEALTH INSURANCE
T72889Medicare UPIN
NJ14959OtherAMERIGROUP OF NJ
NJME0000076-00OtherAMERICHOICE OF NJ