Individual
JEFF ROBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4050 COON RAPIDS BLVD, MERCY HOSPITAL CENTER, COON RAPIDS, MN 55433
(763) 236-7144
(763) 236-7733
Mailing address
5435 FELTL RD, MINNETONKA, MN 55343-7983
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
400615100
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400615100
—
MN
01
—
48027
MN MEDICAL LICENSE
—
Enumeration date
03/18/2006
Last updated
04/07/2010
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