Provider Demographics
NPI:1215231428
Name:HUNDAL, ROBIKA (DPM)
Entity Type:Individual
Prefix:
First Name:ROBIKA
Middle Name:
Last Name:HUNDAL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 LYNDALE AVE SOUTH
Mailing Address - Street 2:SUITE #130
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-3398
Mailing Address - Country:US
Mailing Address - Phone:612-788-8778
Mailing Address - Fax:612-869-3473
Practice Address - Street 1:6600 LYNDALE AVE SOUTH
Practice Address - Street 2:SUITE #130
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-3398
Practice Address - Country:US
Practice Address - Phone:612-788-8778
Practice Address - Fax:612-869-3473
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN851213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
6571310001Medicare NSC
MNC05850Medicare UPIN
MN480000811Medicare PIN