Organization
ROBERT S. ROBITAILLE DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT S ROBITAILLE DO (OWNER)
(651) 232-2036
Entity
Organization
Contact information
Practice address
559 CAPITOL BLVD, SAINT PAUL, MN 55103-2101
(651) 232-2036
(507) 354-2536
Mailing address
PO BOX 1467, BURNSVILLE, MN 55337-0467
(651) 232-2036
(507) 387-7368
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
46841
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111633900
—
MN
01
—
23-00504
MEDICA
MN
01
—
631M4RO
MN BCBS
MN
01
—
C05366
MEDICARE PTAN
MN
Enumeration date
12/17/2006
Last updated
03/29/2011
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