Individual
DR. ROBERT ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11850 BLACKFOOT ST NW, SUITE 490, COON RAPIDS, MN 55433-2578
(763) 427-1137
Mailing address
11850 BLACKFOOT ST NW, SUITE 490, COON RAPIDS, MN 55433-2578
(763) 427-1137
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
36196
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263063000
—
MN
Enumeration date
06/06/2006
Last updated
03/09/2018
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