NPIMap

Organization Active NPI

Robert J Korenberg MD

  • Dermatology Physician
  • Missoula, MT
National Provider Identifier
1881750396
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ROBERT J KORENBERG MD
Practice address
1821 South Ave W
Suite 402
Missoula, MT 59801-6517
Phone
(909) 335-8638
Fax
(909) 335-8644
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Robert J KorenbergNPI 1750382842
Title
MD
Phone
(909) 335-8638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

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

Mailing address

Dept 0873
Denver, CO 80256

National Provider Directory

National Provider Directory

Locations

Dept 0873
Denver, CO 80256

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": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1881750396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 0873",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 SOUTH AVE W",
            "address_2": "SUITE 402",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016517",
            "telephone_number": "909-335-8638",
            "fax_number": "909-335-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J KORENBERG MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "KORENBERG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "909-335-8638"
    },
    "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 Jan 17, 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.