Provider Demographics
NPI:1205174786
Name:ONSTAD, ROBIN M (RT)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:M
Last Name:ONSTAD
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 MEADOW VIEW CT
Mailing Address - Street 2:#301
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7720
Mailing Address - Country:US
Mailing Address - Phone:210-387-7903
Mailing Address - Fax:
Practice Address - Street 1:101 MEADOW VIEW CT
Practice Address - Street 2:#301
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7720
Practice Address - Country:US
Practice Address - Phone:210-387-7903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN176458247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist