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Individual
DR. W ROBERT PROUTY
Active
Individual
DR. W ROBERT PROUTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30159
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030159
TUFTS
—
01
—
042297845
DOC FIRST
MA
01
—
1801887849
MEDICARE
MA
01
—
1801887849
FALLON
—
05
—
1801887849
—
MA
01
—
20882
HARVARD PILGRIM
—
01
—
4218630
AETNA
—
01
—
B10381301
CIGNA
—
Enumeration date
10/31/2005
Last updated
01/03/2011
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