Healthcare Provider Details

I. General information

NPI: 1568404267
Provider Name (Legal Business Name): ROBERT M OBERSTEIN MD, FACE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RETREAT AVE SUITE 400
HARTFORD CT
06106-2528
US

IV. Provider business mailing address

100 RETREAT AVE SUITE 400
HARTFORD CT
06106-2528
US

V. Phone/Fax

Practice location:
  • Phone: 860-547-1278
  • Fax: 860-547-1301
Mailing address:
  • Phone: 860-547-1278
  • Fax: 860-547-1301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number038714
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: