Provider Demographics
NPI:1245657931
Name:SIBERT, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SIBERT
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 1:33150 SCHOOLCRAFT RD
Mailing Address - Street 2:#LO2
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1646
Mailing Address - Country:US
Mailing Address - Phone:734-525-5627
Mailing Address - Fax:248-281-0878
Practice Address - Street 1:33150 SCHOOLCRAFT RD
Practice Address - Street 2:#LO2
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1646
Practice Address - Country:US
Practice Address - Phone:734-525-5627
Practice Address - Fax:248-281-0878
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No171W00000XOther Service ProvidersContractor