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General NPI Number Information
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NPI Number | 1487783536
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Entity Type | Organization
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Legal Business Name | PLYMOUTH BAY INTERNAL MEDICINE
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 45 RESNIK RD SUITE 302
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City | PLYMOUTH
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State | MA
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Zip | 02360-4844
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Country | US
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Telephone | 508-746-2696
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Fax |
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Provider Business Mailing Address
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Address Line | 45 RESNIK RD SUITE 302
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City | PLYMOUTH
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State | MA
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Zip | 02360-4844
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Country | US
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Telephone | 508-746-2696
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY ROBKE
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Credential |
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Telephone | 508-746-2696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 155581
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License Number State | MA
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