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General NPI Number Information
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NPI Number | 1669738969
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Entity Type | Individual
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Provider Name | ROBIN BERSHADER D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 3365 S 103RD ST STE 210
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City | MILWAUKEE
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State | WI
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Zip | 53227-4161
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Country | US
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Telephone | 414-266-3735
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Fax | 414-266-3735
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Provider Business Mailing Address
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Address Line | 8901 E 29TH AVE
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City | DENVER
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State | CO
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Zip | 80238-2708
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Country | US
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Telephone | 516-770-6090
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Fax | 414-266-3735
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 58927
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License Number State | CO
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