Provider Demographics
NPI:1154363828
Name:COBLENTZ, ROBERT H (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:COBLENTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 MARYLAND AVE
Mailing Address - Street 2:APT 4R
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1937
Mailing Address - Country:US
Mailing Address - Phone:412-915-9043
Mailing Address - Fax:
Practice Address - Street 1:654 MARYLAND AVE
Practice Address - Street 2:APT 4R
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1937
Practice Address - Country:US
Practice Address - Phone:412-915-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023818E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009885370001Medicaid
452061OtherBLUE SHIELD
OH2487572Medicaid
PA000988537Medicaid
311354OtherUPMC HEALTH PLAN
WV1810692000Medicaid
7093218OtherAETNA
P00042697OtherRAILROAD MEDICARE
7093218OtherAETNA
E64107Medicare UPIN
PA452061GXEMedicare PIN
PA000988537Medicaid