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NPI Code Detail

MEDICARE: DANIEL R. ROBILLARD P.A.

MEDICARE: DANIEL R. ROBILLARD P.A.
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
1363AM0700XMedical Physician Assistant130-023WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396781688
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL R. ROBILLARD P.A.
Provider Business Mailing Address
First Line : 3238 S 16TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4535
Country : US
Telephone Number : 414-643-4430
Fax Number : 414-643-4693
Provider Business Practice Location Address
First Line : 3238 S 16TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4535
Country : US
Telephone Number : 414-643-4430
Fax Number : 414-643-4693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/08/2007

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