Provider Demographics
NPI:1720274830
Name:MCCARTNEY, ROBERT STEPHEN (RVT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:MCCARTNEY
Suffix:
Gender:M
Credentials:RVT
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:STEPHEN
Other - Last Name:MCCARTNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RVT
Mailing Address - Street 1:3606 BEARD AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2308
Mailing Address - Country:US
Mailing Address - Phone:763-951-3014
Mailing Address - Fax:
Practice Address - Street 1:3606 BEARD AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2308
Practice Address - Country:US
Practice Address - Phone:763-951-3014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19965246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other