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NPI Code Detail

MEDICARE: DR. ROBERT STEVEN LEGROW M.D.

MEDICARE: DR. ROBERT STEVEN LEGROW M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianM3819TX

General Provider Information

NPI Number : 1013908771
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT STEVEN LEGROW M.D.
Provider Business Mailing Address
First Line : 1428 COUNTRY CLUB LN
Second Line :
City : WATERTOWN
State : WI
Zip : 53098-4345
Country : US
Telephone Number : 920-261-8500
Fax Number : 920-261-8828
Provider Business Practice Location Address
First Line : 127 HOSPITAL DR
Second Line :
City : WATERTOWN
State : WI
Zip : 53098-3303
Country : US
Telephone Number : 920-261-8500
Fax Number : 920-261-8828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 04/07/2022

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