Provider Demographics
NPI:1679548747
Name:MONBERG, ROBERT MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MATTHEW
Last Name:MONBERG
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 1:3788 UNIVERSITY AVE S STE 304
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4680
Mailing Address - Country:US
Mailing Address - Phone:907-456-4825
Mailing Address - Fax:907-456-4899
Practice Address - Street 1:3788 UNIVERSITY AVE S STE 304
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4680
Practice Address - Country:US
Practice Address - Phone:907-456-4825
Practice Address - Fax:907-456-4899
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKMEDS3855208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice