Provider Demographics
NPI:1376564898
Name:CATES, ROBERT C SR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:CATES
Suffix:SR
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 1:1904 1ST CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRODHEAD
Mailing Address - State:WI
Mailing Address - Zip Code:53520-1900
Mailing Address - Country:US
Mailing Address - Phone:608-897-2380
Mailing Address - Fax:
Practice Address - Street 1:1904 1ST CENTER AVE
Practice Address - Street 2:
Practice Address - City:BRODHEAD
Practice Address - State:WI
Practice Address - Zip Code:53520-1900
Practice Address - Country:US
Practice Address - Phone:608-897-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-083189207Q00000X
WI30653207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
390808509A1OtherUNITY
90002361OtherWEA INS
1000389OtherPHYSICIANS PLUS
390808509OtherWPS
690004890OtherMEDICARE RAILROAD
31537600OtherHIRSP
390808509OtherCT GENERAL
L18819OtherMEDICARE
10854OtherDEAN HEALTH PLAN
WI31537600Medicaid
390808509OtherCIGNA
80057610OtherMEDICARE RAILROAD
390808509AUOtherUNITY