Provider Demographics
NPI:1306897640
Name:SIVIER, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:SIVIER
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 1:4750 HEMPSTEAD STATION DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5164
Mailing Address - Country:US
Mailing Address - Phone:800-875-0136
Mailing Address - Fax:937-619-4304
Practice Address - Street 1:550 MIRABEAU ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-1617
Practice Address - Country:US
Practice Address - Phone:937-981-2116
Practice Address - Fax:937-981-9238
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.065920207P00000X
OH35065920S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000315932OtherBCBS
OH000000543725OtherANTHEM BCBS
000000319618OtherBLUE CROSS BLUE SHIELD
OH0952643Medicaid
000000316742OtherBCBS MADISON
000000316742OtherBCBS MADISON
OHSI0753839Medicare PIN
OHP00284706Medicare PIN
OH4121743Medicare PIN
OHSI4121742Medicare PIN
OHP00068953Medicare PIN
E16410Medicare UPIN
OHP00089898Medicare PIN