Individual
ROBERT P MADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 1ST DR NW, AUSTIN, MN 55912-2941
(507) 433-7351
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4835
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
37817
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
289073900
—
MN
Enumeration date
05/23/2006
Last updated
10/26/2020
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