Individual
ROBERT M LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 E MAIN ST, MANKATO, MN 56002-8674
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21174
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109799
UCARE
MN
01
—
1201389
MEDICA
MN
05
—
1507723
—
IA
05
—
32427900
—
WI
01
—
370019734
RR MEDICARE
—
01
—
41084933956001C018
CHAMPUS
—
01
—
46D53LA
BCBS
MN
01
—
770978
AMERICAS PPO
MN
05
—
789282900
—
MN
01
—
HP10853
HEALTH PARTNERS
MN
01
—
NA2951027857
PREFERRED ONE
MN
Enumeration date
01/09/2006
Last updated
07/10/2020
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