MEDICARE: ROBERT R. LEITCH 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
1	207R00000X	Internal Medicine Physician	37073	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04-3194547	OTHER	MA	PIONEER PPO
2	000000031613	OTHER	MA	BMC
3	04-3194547	OTHER	MA	CONSOLIDATED
4	04-3194547	OTHER	MA	TRICARE/CHAMPUS
5	037073	OTHER	MA	CONNECTICARE
6	04-3194547	OTHER	MA	NORTH AMERICAN PREFERRED
7	04-3194547	OTHER	MD	PLAN VISTA
8	20589	OTHER	MD	HEALTH NEW ENGLAND
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	66562	OTHER	MA	HARVARD PILGRIM
11	04-3194547	OTHER	MA	NORTHEAST HEALTH DIRECT
12	04-3194547	OTHER	MA	NORTHEAST HEALTHCARE ALLI
13	04-3194547	OTHER	MA	PRIVATE HEALTHCARE SYSTEM
14	6433313	OTHER	MA	CIGNA
15	2517704	OTHER	MA	AETNA
16	J04648	OTHER	MA	BCBSMA
17	04-3194547	OTHER	MA	GREAT-WEST
18	37073	OTHER	MA	TUFTS

General Provider Information

NPI Number	:	1598734188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT R. LEITCH MD

Provider Business Mailing Address
First Line	:	235 GREENFIELD RD
Second Line	:
City	:	SOUTH DEERFIELD
State	:	MA
Zip	:	01373-9790
Country	:	US
Telephone Number	:	413-665-2099
Fax Number	:	413-665-5189

Provider Business Practice Location Address
First Line	:	235 GREENFIELD RD
Second Line	:
City	:	SOUTH DEERFIELD
State	:	MA
Zip	:	01373-9790
Country	:	US
Telephone Number	:	413-665-2099
Fax Number	:	413-665-5189

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	04/05/2012

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