Active NPI
Robert Korenberg MD PC
- Dermatology Physician
- Missoula, MT
National Provider Identifier
1609053511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 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 DirectoryLocations
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.
-
- Medical Physician Assistant
- Missoula, MT
- NPI 1114015617
-
- Physician Assistant
- Princeville, HI
- NPI 1578863924
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.