Robert L Savereide
Individual provider Active NPI Surgery Physician · Ely, MN
NPI 1477591394 · NPPES record last updated Jun 11, 2019
Key facts
- NPI
- 1477591394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 21090 (IA)
- Practice address
- 328 W Conan St
Ely, MN 55731-1145 - Phone
- (218) 365-3271
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 21090 | IA | Yes |
Addresses
Primary practice location
328 W Conan St
Ely, MN 55731-1145
Mailing address
328 W Conan St
Ely, MN 55731-1145
Phone (218) 365-3271
Other practice location 1
2710 Saint Francis Dr
Ste 410
Waterloo, IA 50702-5619
Phone (319) 272-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1149419 | Medicaid | IA |
Other providers in Ely, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.