Provider Demographics
NPI:1881135911
Name:ROBERS, BENJAMIN MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:MICHAEL
Last Name:ROBERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 28TH ST S STE A
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2325
Mailing Address - Country:US
Mailing Address - Phone:701-630-7047
Mailing Address - Fax:701-630-7058
Practice Address - Street 1:825 28TH ST S STE A
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2325
Practice Address - Country:US
Practice Address - Phone:016-307-0477
Practice Address - Fax:701-630-7058
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1881135911OtherNPI