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NPI Code Detail

MEDICARE: ROBERT C DOSS PSYD LP

MEDICARE: ROBERT C DOSS PSYD LP
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
1103G00000XClinical NeuropsychologistLP4254MN

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 : 1669480521
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT C DOSS PSYD LP
Provider Business Mailing Address
First Line : 2720 FAIRVIEW AVE N STE 100
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1306
Country : US
Telephone Number : 651-241-5290
Fax Number : 651-241-5140
Provider Business Practice Location Address
First Line : 2720 FAIRVIEW AVE N STE 100
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1306
Country : US
Telephone Number : 651-241-5290
Fax Number : 651-241-5140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 01/19/2022

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Directions to “ ROBERT C DOSS PSYD LP” Practice Location

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