Individual
ROBERT LARBI-ODAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6014 LAKELAND AVE N, CRYSTAL, MN 55428-2984
(612) 871-2312
(612) 871-2163
Mailing address
6014 LAKELAND AVE N, CRYSTAL, MN 55428-2984
(612) 871-2312
(612) 871-2163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46773
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
660270300
—
MN
Enumeration date
03/24/2006
Last updated
03/31/2023
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