Individual
ROBERT CHARLES SERGOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 WALNUT ST, SUITE 930, PHILADELPHIA, PA 19107-5109
(215) 928-3130
(215) 592-1923
Mailing address
840 WALNUT ST, SUITE 930, PHILADELPHIA, PA 19107-5109
(215) 928-3130
(215) 592-1923
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD018980E
PA
207WX0109X
Neuro-ophthalmology Physician
Primary
MD018980E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000824033
—
PA
01
—
004332
HIGHMARK BLUE SHIELD
PA
01
—
0053049000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
07/21/2005
Last updated
07/21/2022
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