Provider Demographics
NPI:1265414734
Name:POPOVSKI, ROBERT B (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:POPOVSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:19357 E 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-5308
Mailing Address - Country:US
Mailing Address - Phone:586-294-0330
Mailing Address - Fax:586-294-4915
Practice Address - Street 1:19357 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-5308
Practice Address - Country:US
Practice Address - Phone:586-294-0330
Practice Address - Fax:586-294-4915
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101014285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H61468Medicare UPIN