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Organization

ROBERT S. ROBITAILLE DO LLC

Active
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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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