Provider Demographics
NPI:1053387563
Name:HAMBURG, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:HAMBURG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:333 NORTH DOBSON ROAD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4412
Mailing Address - Country:US
Mailing Address - Phone:480-899-2020
Mailing Address - Fax:480-899-9081
Practice Address - Street 1:333 NORTH DOBSON ROAD
Practice Address - Street 2:SUITE 11
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4412
Practice Address - Country:US
Practice Address - Phone:480-899-2020
Practice Address - Fax:480-899-9081
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21505174400000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ141622OtherSTATE AHCCCS NUMBER
AZ141622001OtherAHCCCS MERCYCARE NUMBER
AZ531914OtherAHCCCS MEDICARE CROSSOVER
AZAZ0863170OtherBC/BS OF ARIZONA
AZ060067938OtherRAILROAD MEDICARE NUMBER
AZ20451OtherUNITED HEALTHCARE
AZ337562OtherONE HEALTH PLAN
AZ95964OtherPACIFICARE
AZ2Z0239OtherHEALTHNET OF ARIZONA
AZ3297847021OtherCIGNA HEALTHCARE
AZ860957700OtherHUMANA
AZ2207187OtherAZ PHYSICIANS IPA
AZ100143OtherHEALTHCARE COMPARE AFFORD
AZ95964OtherPACIFICARE
AZF00671Medicare UPIN