Provider Demographics
NPI:1972595072
Name:MCEVOY, ROBERT C (MD)
Entity Type:Individual
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First Name:ROBERT
Middle Name:C
Last Name:MCEVOY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2910 CENTRE POINTE DR
Mailing Address - Street 2:35-121A
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1182
Mailing Address - Country:US
Mailing Address - Phone:651-855-2327
Mailing Address - Fax:651-855-2310
Practice Address - Street 1:347 SMITH AVE N
Practice Address - Street 2:CHILDRENS SPECIALTY CLINIC-DIABETES/ENDOCRINOLOGY-STPL
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2387
Practice Address - Country:US
Practice Address - Phone:651-220-6818
Practice Address - Fax:651-220-6064
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN217802080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B13580Medicare UPIN