Provider Demographics
NPI:1528062858
Name:CONROY, ROBERT WADE (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WADE
Last Name:CONROY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 FAUNCE CORNER RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1242
Mailing Address - Country:US
Mailing Address - Phone:508-996-3991
Mailing Address - Fax:
Practice Address - Street 1:535 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1242
Practice Address - Country:US
Practice Address - Phone:508-996-3991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA796482084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0003724OtherNEIGHBORHOOD HEALTH
MA751021OtherTUFTS/SECURE HORIZON
MA024037OtherBMC HEALTHNET
MA3124924Medicaid
MA9046461001OtherCIGNA
MAJ14566OtherHMO BLUE
MA043402250OtherTAX IDENTIFICATION
MAM16840OtherBCBS
MA11965OtherHARVARD PILGRIM
MA05-00067OtherUNITED HEALTH
MA751021OtherTUFTS/SECURE HORIZON
MACOJ14566Medicare ID - Type Unspecified