Healthcare Provider Details

I. General information

NPI: 1386919777
Provider Name (Legal Business Name): ROBERT FILLER MD, MBA, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S 7TH AVE STE 225
WEST READING PA
19611-1450
US

IV. Provider business mailing address

16 HASTINGS LN
SPRING CITY PA
19475-8614
US

V. Phone/Fax

Practice location:
  • Phone: 484-628-8437
  • Fax:
Mailing address:
  • Phone: 571-432-6123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD469565
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: