Provider Demographics
NPI:1588749907
Name:ROBERT J HUNTER MD INC
Entity type:Organization
Organization Name:ROBERT J HUNTER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REP
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARYCZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:REP
Authorized Official - Phone:570-450-6206
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-0517
Mailing Address - Country:US
Mailing Address - Phone:570-450-6200
Mailing Address - Fax:570-450-6207
Practice Address - Street 1:611 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6552
Practice Address - Country:US
Practice Address - Phone:814-237-7280
Practice Address - Fax:814-234-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014469E207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006051170001Medicaid
PA0006051170001Medicaid
PA094233Medicare ID - Type Unspecified