Provider Demographics
NPI:1992720247
Name:BRIGHAM, ROBERT A (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:BRIGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 S 7TH AVE
Mailing Address - Street 2:SUITE 1070
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1410
Mailing Address - Country:US
Mailing Address - Phone:484-628-2468
Mailing Address - Fax:484-628-2467
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:SUITE 1070
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:484-628-2468
Practice Address - Fax:484-628-2467
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043589E2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001390519Medicaid
PA001390519Medicaid
PA470706Medicare PIN