Provider Demographics
NPI:1487620910
Name:SIBILIA, ROBERT V (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:V
Last Name:SIBILIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:324 E MILLTOWN ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1248
Mailing Address - Country:US
Mailing Address - Phone:330-345-2856
Mailing Address - Fax:330-345-3756
Practice Address - Street 1:324 E MILLTOWN ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1248
Practice Address - Country:US
Practice Address - Phone:330-345-2856
Practice Address - Fax:330-345-3756
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068478207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000142173OtherANTHEM
OH0155755Medicaid
3419168938ALLOtherHIGHMARK BCBS
RO0781965OtherMEDICARE SECONDAY
290012574OtherUNITED HEALTHCARE
341916893RSOtherSUMMA
4900520001OtherADMINISTAR FEDERAL
000000142173OtherANTHEM
4900520001OtherADMINISTAR FEDERAL
F37758Medicare UPIN
OH4900520001Medicare NSC
OH0781965Medicare PIN