Roberts, William Oliver

Roberts, William Oliver is an individual health care provider with primary practice located at Ufp Phalen Village Clinic 1414 Maryland Avenue East, Saint Paul MN 55106. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Roberts, William Oliver can be contacted via phone (651) 772-3461.

Contact Information

Primary practice address
Ufp Phalen Village Clinic 1414 Maryland Avenue East Saint Paul MN 55106
Phone: (651) 772-3461
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24845 Minnesota
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 24845 Minnesota

Profile Details

NPI number 1154404952
LBN Legal business name Roberts, William Oliver
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated May 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154404952 NPPES
Minnesota Other 01-12528 MEDICA PRIMARY
Minnesota Other 102775 MEDICA PRIMARY
Minnesota Other 0506013 MEDICA PRIMARY
Minnesota Other 01-12528 MEDICA PRIMARY
Minnesota MEDICAID 681282100 MEDICA PRIMARY
Minnesota Other 1780296 MEDICA PRIMARY
Minnesota Other 061L6RO MEDICA PRIMARY
Minnesota Other HP17043 MEDICA PRIMARY
Minnesota MEDICAID 1519736 MEDICA PRIMARY

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