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NPI Code Detail

MEDICARE: MR. ROBERT DANIEL MALTZ MD

MEDICARE:  MR. ROBERT DANIEL MALTZ  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician7069RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11893OTHERRINEIGHBORHOOD HEALTH PLAN
21200223OTHERUNITED HEALTH
3710054201OTHERCIGNA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5004050OTHERBLUE CHIP

General Provider Information

NPI Number : 1033146931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT DANIEL MALTZ MD
Provider Business Mailing Address
First Line : 10 DAVOL SQ
Second Line : SUITE 400
City : PROVIDENCE
State : RI
Zip : 02903-4754
Country : US
Telephone Number : 401-421-4000
Fax Number : 401-272-1456
Provider Business Practice Location Address
First Line : 65 VILLAGE SQUARE DR
Second Line : SUITE 101
City : SOUTH KINGSTOWN
State : RI
Zip : 02879-2292
Country : US
Telephone Number : 401-789-5924
Fax Number : 401-782-1770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 01/18/2016

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Directions to “ MR. ROBERT DANIEL MALTZ MD” Practice Location

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