Provider Demographics
NPI:1235405572
Name:ROBIN'S NEST PEDIATRICS
Entity type:Organization
Organization Name:ROBIN'S NEST PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:605-554-2300
Mailing Address - Street 1:875 DAKOTA AVE S STE 2
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-2772
Mailing Address - Country:US
Mailing Address - Phone:605-554-2300
Mailing Address - Fax:605-554-2302
Practice Address - Street 1:875 DAKOTA AVE S STE 2
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2772
Practice Address - Country:US
Practice Address - Phone:605-554-2300
Practice Address - Fax:605-554-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7901208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty