Provider Demographics
NPI:1568656627
Name:ROBERT L KALB MD INC
Entity Type:Organization
Organization Name:ROBERT L KALB MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KALB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-472-3791
Mailing Address - Street 1:3900 SUNFOREST CT
Mailing Address - Street 2:SUITE 119
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4475
Mailing Address - Country:US
Mailing Address - Phone:419-472-3791
Mailing Address - Fax:419-472-6219
Practice Address - Street 1:3900 SUNFOREST CT
Practice Address - Street 2:SUITE 119
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4475
Practice Address - Country:US
Practice Address - Phone:419-472-3791
Practice Address - Fax:419-472-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0515455Medicaid
OH0450116Medicare PIN
OHCO1558Medicare UPIN
OH4185330001Medicare NSC