Basic Information
| Provider Information | |||||||||
| NPI: | 1982670857 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 MOUNT AUBURN ST | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021385600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174971560 | ||||||||
| FaxNumber: | 6174971109 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 MOUNT AUBURN ST | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021385600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174971560 | ||||||||
| FaxNumber: | 6174971109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2006 | ||||||||
| LastUpdateDate: | 04/13/2011 | ||||||||
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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 | 207RC0000X | 54211 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 3270 | 01 | MA | HARVARD PILGRIM HEALTH PLAN | OTHER | 60677 | 01 | MA | FALLON | OTHER | 99184402 | 01 | MD | NETWORK HEALTH PLAN | OTHER | 1982670857 | 01 | MA | BOSTON MEDICAL CENTER HEALTH NET PLAN | OTHER | 4035976 | 01 | MA | AETNA HEALTHCARE | OTHER | 703440 | 01 | MA | TUFTS | OTHER | 3029034 | 05 | MA | MEDICAID | 0015127 | 01 | MA | CIGNA HEALTHPLAN | OTHER | 0015761 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | J06935 | 01 | MA | BCBS | OTHER |