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Individual
ROBERT A VENNERSTROM
Active
Individual
ROBERT A VENNERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33413
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00794
MEDICAFFMG&WRC
MN
01
—
01-14533
MEDICABLC
MN
05
—
093007500
—
MN
01
—
1008800
PREFERREDONE
MN
01
—
109371
UCAREMN
MN
05
—
200383400A
—
IN
05
—
232419
—
OR
05
—
41091744413
—
NE
01
—
80532VE
BCBS
MN
05
—
806646400
—
ID
01
—
HP27402
HEALTHPARTNERS
MN
Enumeration date
09/26/2006
Last updated
02/16/2017
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