Provider Demographics
NPI:1518295260
Name:VENEGONI, ROBERT LOUIS (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LOUIS
Last Name:VENEGONI
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 1:5021 SCRIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-1159
Mailing Address - Country:US
Mailing Address - Phone:952-936-0534
Mailing Address - Fax:
Practice Address - Street 1:5021 SCRIVER ROAD
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-1159
Practice Address - Country:US
Practice Address - Phone:952-936-0534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20608207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology