Provider Demographics
NPI:1871603795
Name:LAURENCE, ROBERT P (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:LAURENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:760 COMMERICAL STREET
Mailing Address - Street 2:PO BOX 548
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856
Mailing Address - Country:US
Mailing Address - Phone:207-594-5151
Mailing Address - Fax:207-594-2261
Practice Address - Street 1:760 COMMERICAL STREET
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856
Practice Address - Country:US
Practice Address - Phone:207-594-5151
Practice Address - Fax:207-594-2261
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME009417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B86276Medicare UPIN
ME077540Medicare PIN