Individual
ROBERT M ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
135 GOLD STAR BLVD, WORCESTER, MA 01606
(508) 853-2716
(508) 856-9025
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605
(508) 853-2716
(508) 856-9025
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
38051
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
ONE HEALTH PLAN
—
01
—
1150042
FIRST HEALTH
—
01
—
2034107
MEDICAID WELFARE
—
05
—
2034107
—
MA
01
—
26802
HEALTHY START
—
01
—
300090862
RAILROAD MEDICARE
—
01
—
4476761
CIGNA HEALTH PLAN
—
01
—
5635531
AETNA
—
01
—
784213
MVP HEALTH CARE
—
01
—
9900863
FALLON COMMUNITY HEALTH P
—
01
—
AA4010
HARVARD PILGRIM HEALTH CA
—
01
—
C05097
BLUE SHIELD INDEMNITY
—
Enumeration date
02/22/2006
Last updated
02/03/2009
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