Robert Arthur Brogan, MD

Individual provider Active NPI Pediatric Adolescent Medicine Physician · East Greenwich, RI

NPI 1639260656 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1639260656
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Adolescent Medicine Physician 2080A0000X
License
03183 (RI)
Practice address
27 Division St
East Greenwich, RI 02818-3872
Phone
(401) 884-2150
Fax
(401) 884-1750
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
03183RIMDPediatric Adolescent Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 03183 RI Yes

Addresses

Primary practice location

27 Division St
East Greenwich, RI 02818-3872

Mailing address

27 Division St
East Greenwich, RI 02818-3872
Phone (401) 884-2150

Other identifiers

IdentifierTypeStateIssuer
00010MedicaidRI
000340OtherRIBLUE CHIP OF RHODE ISLAND
3747OtherRINEIGHBORHOOD HEALTH PLAN
1200100OtherRIUNITED HEALTH PLAN
406-494OtherRITUFTS HEALTH PLAN
148-1OtherRIBLUE CROSS OF RHODE ISLAN

Other providers in East Greenwich, RI

All providers in East Greenwich, RI · Pediatric Adolescent Medicine Physician in Rhode Island

Sources for this page

Verify at the official NPI Registry.