Individual
MARK R ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
43835
WI
207R00000X
Internal Medicine Physician
Primary
57061
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43495500
—
WI
Enumeration date
09/15/2006
Last updated
11/25/2019
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