Provider Demographics
NPI:1326001389
Name:HOVDA, ROBERT NERVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NERVIN
Last Name:HOVDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 CENTRAL AVE NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2968
Mailing Address - Country:US
Mailing Address - Phone:763-782-8183
Mailing Address - Fax:763-782-8100
Practice Address - Street 1:4000 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2968
Practice Address - Country:US
Practice Address - Phone:763-782-8183
Practice Address - Fax:763-782-8100
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN793863200Medicaid
MN4044535OtherAETNA
MN6603850OtherMEDICA UC
MN0108773OtherMEDICA
MN1000843OtherPREFERRED ONE
MN107296OtherUCARE MN
MN08F36HOOtherBCBS OF MN
MN21531OtherAMERICA'S PPO
MNHP19907OtherHEALTHPARTNERS
MN080001295Medicare ID - Type Unspecified
MN08F36HOOtherBCBS OF MN
MN6603850OtherMEDICA UC