Healthcare Provider Details

I. General information

NPI: 1629334214
Provider Name (Legal Business Name): ROBERT L. TOKARS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 10/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 HOLY CROSS PKWY
MISHAWAKA IN
46545
US

IV. Provider business mailing address

PO BOX 1742
SOUTH BEND IN
46634-1742
US

V. Phone/Fax

Practice location:
  • Phone: 574-335-5000
  • Fax:
Mailing address:
  • Phone: 574-233-3123
  • Fax: 574-233-3125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01078422A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: