Provider Demographics
NPI:1912123142
Name:LOCKE, ROBIN E (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:E
Last Name:LOCKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:361 OLD BELGRADE RD
Mailing Address - Street 2:ALFOND CANCER CENTER
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8058
Mailing Address - Country:US
Mailing Address - Phone:207-621-6100
Mailing Address - Fax:207-621-6102
Practice Address - Street 1:361 OLD BELGRADE RD
Practice Address - Street 2:ALFOND CANCER CENTER
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8058
Practice Address - Country:US
Practice Address - Phone:207-621-6100
Practice Address - Fax:207-621-6102
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241974207RH0003X
ME018128207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME434163299Medicaid
ME1912123142Medicaid
ME001113201Medicare PIN
ME1912123142Medicaid