Provider Demographics
NPI:1578625398
Name:ENGSTROM, ROBYN S (MD)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:S
Last Name:ENGSTROM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ISU THOMAS B THIELEN STUDENT HEALTH CTR
Mailing Address - Street 2:UNION & SHELDON DR
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50011-0001
Mailing Address - Country:US
Mailing Address - Phone:515-294-5801
Mailing Address - Fax:515-294-7180
Practice Address - Street 1:ISU THOMAS B THIELEN STUDENT HEALTH CTR
Practice Address - Street 2:UNION & SHELDON DR
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50011-0001
Practice Address - Country:US
Practice Address - Phone:515-294-5801
Practice Address - Fax:515-294-7180
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA25579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA06797OtherBCBS
IA1030700Medicaid
IA06797OtherBCBS