Healthcare Provider Details
I. General information
NPI: 1780787275
Provider Name (Legal Business Name): HUGH D ROBERTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/07/2006
Last Update Date: 01/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48 SANDERSON STREET
GREENFIELD MA
01301-2778
US
IV. Provider business mailing address
280 CHESTNUT ST 2ND FLOOR
SPRINGFIELD MA
01199-1001
US
V. Phone/Fax
- Phone: 413-773-2022
- Fax: 413-773-4945
- Phone: 413-794-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 52652 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: