Provider Demographics
NPI:1548246382
Name:BAHR, ROBERT L (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:BAHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E MANNING ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5109
Mailing Address - Country:US
Mailing Address - Phone:401-272-2020
Mailing Address - Fax:401-421-5979
Practice Address - Street 1:150 E MANNING ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5109
Practice Address - Country:US
Practice Address - Phone:401-272-2020
Practice Address - Fax:401-421-5979
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05032207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI153555OtherHARVARD
RI0583135OtherCIGNA
RI0859OtherNHP RI - GROUP #
MAM17477OtherBCBS MASS GROUP #
RI1618OtherNEIGHBORHOOD RI
MAJ04639OtherBLUE CROSS - MASSACHUSETT
MA0021765OtherNEIGHBORHOOD MA
RI08-00125OtherUNITED
RI26587OtherRI BLUE SHIELD
MA4236-3OtherBCBS RI - MASS GROUP #
RI738346OtherTUFTS
RI603940OtherTUFTS - GROUP #
RI000187OtherBLUE CHIP
RI180036711OtherRAILROAD MEDICARE
RI5827188OtherAETNA
RI7000871Medicaid
MA9782486Medicaid
MAM17477OtherBCBS MASS GROUP #
RI180036711OtherRAILROAD MEDICARE
RI7000871Medicaid