Provider Demographics
NPI:1093823189
Name:ROBINSON, STEPHEN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WILLIAM
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6401 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4341
Mailing Address - Country:US
Mailing Address - Phone:763-572-5710
Mailing Address - Fax:763-571-3008
Practice Address - Street 1:13819 HANSON BLVD NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-7608
Practice Address - Country:US
Practice Address - Phone:763-572-5710
Practice Address - Fax:763-862-4490
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2012-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN39864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN122096OtherUCARE MN
MNHP29060OtherHEALTHPARTNERS
MN1020257OtherPREFERRED ONE
MN7061030OtherAETNA INS
MN0116281OtherMEDICA
MN850751OtherAMERICA'S PPO
MN6603856OtherMEDICA URGENT CARE
MN807722300Medicaid
MN68D54ROOtherBCBS OF MN
MN850751OtherAMERICA'S PPO
MNHP29060OtherHEALTHPARTNERS
MN68D54ROOtherBCBS OF MN