Basic Information
| Provider Information | |||||||||
| NPI: | 1730111972 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | GARY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX D | ||||||||
| Address2: | |||||||||
| City: | NEW YORK MILLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 565670364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2183851800 | ||||||||
| FaxNumber: | 2183851830 | ||||||||
| Practice Location | |||||||||
| Address1: | 737 BROADWAY N | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581220001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012344811 | ||||||||
| FaxNumber: | 7012346979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 27369 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.