Basic Information
| Provider Information | |||||||||
| NPI: | 1336120377 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VANDERLIN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020619147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7818717418 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 PERFORMANCE DR | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021893104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816828000 | ||||||||
| FaxNumber: | 7813351412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 02/10/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 49353 | MA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | MA | PRIVATE HEALTHCARE SYSTEM | OTHER | 042297845 | 01 | MA | UHC | OTHER | 136225 | 01 | MA | HVD PILGRIM HEALTH CARE | OTHER | 6181872 | 05 | MA | MEDICAID | 042297845 | 01 | MA | UNITED HEALTH CARE | OTHER | 049353 | 01 | MA | TUFTS | OTHER | 042297845 | 01 | MA | HCVM | OTHER | 042297845 | 01 | MA | DOC FIRST | OTHER | 042297845 | 01 | MA | TRICARE | OTHER | 34726 | 01 | MA | FALLON | OTHER | 4218639 | 01 | MA | AETNA | OTHER | 042297845 | 01 | MA | GIC UNICARE | OTHER | 042297845 | 01 | MA | GREAT WEST HEALTH CARE | OTHER | J03518 | 01 | MA | BCBS | OTHER | 6181872 | 01 | MA | NEIGHBORHOOD HLTH PLAN | OTHER | 702028 | 01 | MA | TUFTS MEDICARE PREFERRED | OTHER | B2082201 | 01 | MA | CIGNA | OTHER |