Provider Demographics
NPI:1942900428
Name:KOHLBACHER, ROBERT SLOAN
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SLOAN
Last Name:KOHLBACHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 HUAN ZHEN NAN LU #46
Mailing Address - Street 2:
Mailing Address - City:SHANGHAI
Mailing Address - State:SHANGHAI
Mailing Address - Zip Code:201103
Mailing Address - Country:CN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 HUAN ZHEN NAN LU #46
Practice Address - Street 2:
Practice Address - City:SHANGHAI
Practice Address - State:SHANGHAI
Practice Address - Zip Code:201103
Practice Address - Country:CN
Practice Address - Phone:861-851-2107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18764207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine