Provider Demographics
NPI:1992870497
Name:JANETT, ROBERT S (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:JANETT
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 1:237 HAMPSHIRE ST
Mailing Address - Street 2:CAMBRIDGE FAMILY HEALTH
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1389
Mailing Address - Country:US
Mailing Address - Phone:617-575-5570
Mailing Address - Fax:
Practice Address - Street 1:237 HAMPSHIRE ST
Practice Address - Street 2:CAMBRIDGE FAMILY HEALTH
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1389
Practice Address - Country:US
Practice Address - Phone:617-575-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3019055Medicaid
MA1211978Medicaid
MA1211978Medicaid