MEDICARE: ROBERT W PATTILLO M.D.

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
1	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	MD049479L	PA
2	207RC0000X	Cardiovascular Disease Physician	25MA09809000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821077355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT W PATTILLO M.D.

Provider Business Mailing Address
First Line	:	211 S MAIN ST
Second Line	:	STE 205
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2264
Country	:	US
Telephone Number	:	609-463-0800
Fax Number	:	609-463-0957

Provider Business Practice Location Address
First Line	:	211 S MAIN ST
Second Line	:	STE 205
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2264
Country	:	US
Telephone Number	:	609-463-0800
Fax Number	:	609-463-0957

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	11/10/2020

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