Provider Demographics
NPI:1801856307
Name:SEVENICH, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SEVENICH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:559 CAPITOL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2101
Mailing Address - Country:US
Mailing Address - Phone:651-232-2000
Mailing Address - Fax:651-232-2118
Practice Address - Street 1:559 CAPITOL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2101
Practice Address - Country:US
Practice Address - Phone:651-232-2000
Practice Address - Fax:651-232-2118
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN329172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF77576Medicare UPIN