Provider Demographics
NPI:1487995999
Name:ROBERT LEBOW, MD, CMD, FACP
Entity type:Organization
Organization Name:ROBERT LEBOW, MD, CMD, FACP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-765-9522
Mailing Address - Street 1:38 OAKES AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-4012
Mailing Address - Country:US
Mailing Address - Phone:508-765-9522
Mailing Address - Fax:508-764-7870
Practice Address - Street 1:38 OAKES AVE
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-4012
Practice Address - Country:US
Practice Address - Phone:508-765-9522
Practice Address - Fax:508-764-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty