# ROBAK MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Skinclusive Dermatology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386371557
- **Authorized official:** KELCEY ROBAK PA (CEO)
- **Authorized official phone:** (402) 276-7038

## Contact information

- **Practice address:** 1318 15TH ST, COLUMBUS, NE 68601-5224
- **Practice address phone:** (402) 276-7038
- **Mailing address:** 1318 15TH ST, COLUMBUS, NE 68601-5224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 08/06/2022
- **Last updated:** 12/23/2022