Healthcare Provider Details

I. General information

NPI: 1659377497
Provider Name (Legal Business Name): ROBERT L KALB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 HILL ST
BUCYRUS OH
44820-1566
US

IV. Provider business mailing address

3900 SUNFOREST CT SUITE 119
TOLEDO OH
43623-4475
US

V. Phone/Fax

Practice location:
  • Phone: 419-562-5281
  • Fax:
Mailing address:
  • Phone: 419-472-3791
  • Fax: 419-472-6219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35-04-0904-K
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: