Individual
WILLIAM OLIVER ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
UFP PHALEN VILLAGE CLINIC, 1414 MARYLAND AVENUE EAST, SAINT PAUL, MN 55106
(651) 772-3461
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MINNEAPOLIS, MN 55455
(651) 772-3461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24845
MN
207QS0010X
Sports Medicine (Family Medicine) Physician
24845
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-12528
MEDICA PRIMARY
MN
01
—
0506013
PREFERRED ONE
MN
01
—
061L6RO
BLUE CROSS BLUE SHIELD
MN
01
—
102775
UCARE
MN
05
—
1519736
—
IA
01
—
1780296
ARAZ
MN
05
—
681282100
—
MN
01
—
HP17043
HEALTH PARTNERS
MN
Enumeration date
10/23/2006
Last updated
05/11/2012
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