Provider Demographics
NPI:1548474257
Name:BOYD, ROBERT D (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:BOYD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:270 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1927
Mailing Address - Country:US
Mailing Address - Phone:732-636-5252
Mailing Address - Fax:732-636-5452
Practice Address - Street 1:270 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1927
Practice Address - Country:US
Practice Address - Phone:732-636-5252
Practice Address - Fax:732-636-5452
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03033500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000728Medicare PIN