Provider Demographics
NPI:1427009893
Name:SJOBERG, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SJOBERG
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 1:1011 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2242
Mailing Address - Country:US
Mailing Address - Phone:218-249-7890
Mailing Address - Fax:218-249-7899
Practice Address - Street 1:1011 E 1ST ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2242
Practice Address - Country:US
Practice Address - Phone:218-249-7890
Practice Address - Fax:218-249-7899
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN32989207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN559797100Medicaid
MN460002270OtherMEDICARE RR
MN460002270OtherMEDICARE RR
MN460000142Medicare PIN
MNE41998Medicare UPIN