Provider Demographics
NPI:1356348031
Name:CESAREC, ROBERT GEORGE (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GEORGE
Last Name:CESAREC
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 LONE OAK LN
Mailing Address - Street 2:HARTFORD HEALTH CENTER
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-2600
Mailing Address - Country:US
Mailing Address - Phone:262-670-1800
Mailing Address - Fax:262-836-1601
Practice Address - Street 1:110 LONE OAK LN
Practice Address - Street 2:HARTFORD HEALTH CENTER
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-2600
Practice Address - Country:US
Practice Address - Phone:262-670-1800
Practice Address - Fax:262-836-1601
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI22316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30372700Medicaid
WI1356348031Medicaid
B52001Medicare UPIN