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NPI Code Detail

MEDICARE: BONNIE J ROHR MD

MEDICARE: BONNIE J ROHR MD
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 Physician32747MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
140815OTHERWIMEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124136924
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE J ROHR MD
Provider Business Mailing Address
First Line : PO BOX 1309
Second Line : MAIL STOP 21110Q
City : MINNEAPOLIS
State : MN
Zip : 55440-1309
Country : US
Telephone Number : 651-552-2600
Fax Number : 651-552-2614
Provider Business Practice Location Address
First Line : 5625 CENEX DR
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1724
Country : US
Telephone Number : 651-552-2600
Fax Number : 651-552-2614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/01/2015

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