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Individual

ROBERT EMANUEL NORDBERG JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 265-3300
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 265-3300

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
118288
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001018200
BLUE CROSS BLUE SHIELD
05
01013010
NY
01
1182880
WORKERS COMP
NY
Enumeration date
07/12/2006
Last updated
03/31/2021
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