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General NPI Number Information
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NPI Number | 1245893122
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Entity Type | Individual
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Provider Name | ROBERT WEI GAO MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 11850 BLACKFOOT ST NW STE 150
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City | COON RAPIDS
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State | MN
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Zip | 55433-2583
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Country | US
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Telephone | 763-433-0221
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Fax |
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Provider Business Mailing Address
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Address Line | 7401 METRO BLVD STE 210
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City | EDINA
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State | MN
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Zip | 55439-3086
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Country | US
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Telephone | 952-920-4915
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Fax | 952-915-6091
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 67924
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License Number State | MN
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