Provider Demographics
NPI:1942285796
Name:POIRIER, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:POIRIER
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 1:860 BETHESDA DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1800
Mailing Address - Country:US
Mailing Address - Phone:740-454-4651
Mailing Address - Fax:740-454-4653
Practice Address - Street 1:42 E 3RD ST
Practice Address - Street 2:
Practice Address - City:FRAZEYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43822-9651
Practice Address - Country:US
Practice Address - Phone:740-828-1020
Practice Address - Fax:740-828-9089
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1586OtherGROUP MEDICARE RAILROAD
OH000000185162OtherANTHEM PIN
OH0989499OtherGROUP MEDICAID
OH000000177775OtherUNISON PIN
OH311413469032OtherCARESOURCE PIN
PO4030321OtherMEDICARE PTAN
OH2204153Medicaid
OH0105421OtherUHC PIN
OH080161106OtherMEDICARE RAILROAD
OH0989499OtherGROUP MEDICAID
PO4030321OtherMEDICARE PTAN
OH2204153Medicaid