Provider Demographics
NPI:1992969430
Name:FEAR, ROBERT EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDWARD
Last Name:FEAR
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 1:229 TOYLSOME LANE
Mailing Address - Street 2:BOX 1577
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11969-1577
Mailing Address - Country:US
Mailing Address - Phone:631-283-4140
Mailing Address - Fax:
Practice Address - Street 1:229 TOYLSOME LANE
Practice Address - Street 2:BOX 1577
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11969-1577
Practice Address - Country:US
Practice Address - Phone:631-283-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090534208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice