Provider Demographics
NPI:1376649970
Name:FACTOR, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:FACTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16 N CARROLL ST STE 450
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2784
Mailing Address - Country:US
Mailing Address - Phone:608-263-6025
Mailing Address - Fax:608-888-1797
Practice Address - Street 1:16 N CARROLL ST STE 450
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-2784
Practice Address - Country:US
Practice Address - Phone:608-263-6025
Practice Address - Fax:608-263-6025
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI23039-0202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30368800Medicaid
WIB52687Medicare UPIN
WIWI1926001Medicare PIN