MEDICARE: DAVID ROBILLARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	79-257	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518923820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ROBILLARD MD

Provider Business Mailing Address
First Line	:	2410 W PIERCE ST
Second Line	:
City	:	CARLSBAD
State	:	NM
Zip	:	88220-3512
Country	:	US
Telephone Number	:	505-885-0766
Fax Number	:

Provider Business Practice Location Address
First Line	:	2410 W PIERCE ST
Second Line	:
City	:	CARLSBAD
State	:	NM
Zip	:	88220-3512
Country	:	US
Telephone Number	:	505-885-0766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID ROBILLARD MD” Practice Location

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