Healthcare Provider Details

I. General information

NPI: 1679592745
Provider Name (Legal Business Name): MICHAEL EDWARD ROBIOLIO M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 MAIN ST
DARLINGTON WI
53530-1426
US

IV. Provider business mailing address

13645 WILDCAT RD
DARLINGTON WI
53530-9110
US

V. Phone/Fax

Practice location:
  • Phone: 608-482-2005
  • Fax: 855-574-5406
Mailing address:
  • Phone: 608-482-2005
  • Fax: 855-574-5406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35208-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: