Provider Demographics
NPI:1568404267
Name:OBERSTEIN, ROBERT M (MD, FACE)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:OBERSTEIN
Suffix:
Gender:M
Credentials:MD, FACE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RETREAT AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2528
Mailing Address - Country:US
Mailing Address - Phone:860-547-1278
Mailing Address - Fax:860-547-1301
Practice Address - Street 1:100 RETREAT AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2528
Practice Address - Country:US
Practice Address - Phone:860-547-1278
Practice Address - Fax:860-547-1301
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038714207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001387142Medicaid
CTG49422Medicare UPIN
CT460000038Medicare ID - Type Unspecified