Provider Demographics
NPI:1386682136
Name:QUIGLEY, ROBERT L (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:QUIGLEY
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 1:814 CONSHOHOCKEN STATE RD
Mailing Address - Street 2:
Mailing Address - City:GLADWYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19035-1428
Mailing Address - Country:US
Mailing Address - Phone:610-519-9375
Mailing Address - Fax:
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:SUITE 214
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-056209L208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30018180OtherKEYSTONE MERCY
PA3857715OtherAETNA
PA2349433000OtherINDEPENDENCE BLUE CROSS
PA0015347900010Medicaid
PA3949422OtherAETNA HMO
PA2349433000OtherINDEPENDENCE BLUE CROSS
PA30018180OtherKEYSTONE MERCY