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General NPI Number Information
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NPI Number | 1972935583
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Entity Type | Individual
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Provider Name | ROBERT LEE MARCACCINI MD, PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 3701 12TH ST N STE 100
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City | SAINT CLOUD
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State | MN
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Zip | 56303-2253
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Country | US
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Telephone | 320-253-7257
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Fax | 320-251-2938
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Provider Business Mailing Address
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Address Line | 1200 6TH AVE N
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City | SAINT CLOUD
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State | MN
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Zip | 56303-2735
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Country | US
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Telephone | 320-251-2700
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Fax | 320-656-7115
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A195410
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 121293
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 76540
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License Number State | MN
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