Provider Demographics
NPI:1710092127
Name:ROBBEN, NORBERTUS C (MD)
Entity Type:Individual
Prefix:DR
First Name:NORBERTUS
Middle Name:C
Last Name:ROBBEN
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 1:504 BROOKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4008
Mailing Address - Country:US
Mailing Address - Phone:610-446-6533
Mailing Address - Fax:
Practice Address - Street 1:2010 W CHESTER PIKE STE 345
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2738
Practice Address - Country:US
Practice Address - Phone:610-924-0800
Practice Address - Fax:610-999-0799
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044142L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA512679OtherUSHC
PA1247441Medicaid
PAE88324Medicare UPIN
PA674852Medicare ID - Type Unspecified