MEDICARE: ROBERT T ROHLOFF 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
1	208000000X	Pediatrics Physician	24607	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1679569297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT T ROHLOFF M.D.

Provider Business Mailing Address
First Line	:	14555 W NATIONAL AVE
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53151-4494
Country	:	US
Telephone Number	:	262-789-6020
Fax Number	:	262-789-6025

Provider Business Practice Location Address
First Line	:	4855 S MOORLAND RD STE 250
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53151-7494
Country	:	US
Telephone Number	:	262-789-6020
Fax Number	:	262-789-6025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/21/2022

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