Roberts, Mark R

Roberts, Mark R is an individual health care provider with primary practice located at 1500 Curve Crest Blvd W , Stillwater MN 55082-6040. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Roberts, Mark R can be contacted via phone (651) 439-1234.

Contact Information

Primary practice address
1500 Curve Crest Blvd W Stillwater MN 55082-6040
Phone: (651) 439-1234
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 43835 Wisconsin
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 57061 Minnesota

Profile Details

NPI number 1386740843
LBN Legal business name Roberts, Mark R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Nov 25th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386740843 NPPES
Wisconsin MEDICAID 43495500

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