Provider Demographics
NPI:1568452175
Name:AMIOT, ROBBY A (DPM)
Entity Type:Individual
Prefix:
First Name:ROBBY
Middle Name:A
Last Name:AMIOT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19475 W NORTH AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4199
Mailing Address - Country:US
Mailing Address - Phone:262-395-4160
Mailing Address - Fax:262-395-4159
Practice Address - Street 1:19475 W NORTH AVE
Practice Address - Street 2:STE 201
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4199
Practice Address - Country:US
Practice Address - Phone:262-395-4160
Practice Address - Fax:262-395-4159
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI868025213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43239700Medicaid
WI43239700Medicaid
WIV005036Medicare UPIN