Roberts, William Oliver
Roberts, William Oliver is an individual health care provider with primary practice located at Ufp Phalen Village Clinic 1414 Maryland Avenue East, Saint Paul MN 55106. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Roberts, William Oliver can be contacted via phone (651) 772-3461.Contact Information
Primary practice address
Ufp Phalen Village Clinic 1414 Maryland Avenue East
Saint Paul MN 55106
Phone: (651) 772-3461
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 24845 | Minnesota |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 24845 | Minnesota |
Profile Details
| NPI number | 1154404952 |
|---|---|
| LBN Legal business name | Roberts, William Oliver |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | May 11th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154404952 | NPPES |
| Minnesota | Other | 01-12528 | MEDICA PRIMARY |
| Minnesota | Other | 102775 | MEDICA PRIMARY |
| Minnesota | Other | 0506013 | MEDICA PRIMARY |
| Minnesota | Other | 01-12528 | MEDICA PRIMARY |
| Minnesota | MEDICAID | 681282100 | MEDICA PRIMARY |
| Minnesota | Other | 1780296 | MEDICA PRIMARY |
| Minnesota | Other | 061L6RO | MEDICA PRIMARY |
| Minnesota | Other | HP17043 | MEDICA PRIMARY |
| Minnesota | MEDICAID | 1519736 | MEDICA PRIMARY |
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