Provider Demographics
NPI:1144338278
Name:KOHLWES, ROBERT JEFFERY (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEFFERY
Last Name:KOHLWES
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 HOMESTEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-4427
Mailing Address - Country:US
Mailing Address - Phone:415-381-7967
Mailing Address - Fax:415-750-6982
Practice Address - Street 1:4150 CLEMENT STREET
Practice Address - Street 2:VETERANS AFFAIRS HOSPITAL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-6974
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2011-03-09
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2011-03-09
Provider Licenses
StateLicense IDTaxonomies
WAMD33886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine