Organization Active NPI

Robert Korenberg MD PC

  • Dermatology Physician
  • Missoula, MT
National Provider Identifier
1609053511
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ROBERT KORENBERG MD PC
Practice address
1821 South Ave W
Ste 402
Missoula, MT 59801-6517
Phone
(406) 543-8512
Fax
(406) 541-8513
NPI assigned
Jan 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Korenberg, M.D.
Title
President
Phone
(406) 543-8512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1821 South Ave W
Ste 402
Missoula, MT 59801-6517

Mailing address

1821 South Ave W
Ste 402
Missoula, MT 59801-6517
Phone (406) 543-8512

National Provider Directory

National Provider Directory

Locations

1821 South Ave W
Ste 402
Missoula, MT 59801
Phone (406) 541-8512

1821 South Ave W
Missoula, MT 59801
Phone (406) 493-0844

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1609053511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 SOUTH AVE W",
            "address_2": "STE 402",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016517",
            "telephone_number": "406-543-8512",
            "fax_number": "406-541-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 SOUTH AVE W",
            "address_2": "STE 402",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016517",
            "telephone_number": "406-543-8512",
            "fax_number": "406-541-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT KORENBERG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "KORENBERG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-543-8512",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.