Provider Demographics
NPI:1548478555
Name:WEBSTER, ROBERT MARK (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1999
Mailing Address - Country:US
Mailing Address - Phone:406-563-8500
Mailing Address - Fax:406-563-8694
Practice Address - Street 1:171 CASEY MEADOW RD
Practice Address - Street 2:
Practice Address - City:CLANCY
Practice Address - State:MT
Practice Address - Zip Code:59634-9565
Practice Address - Country:US
Practice Address - Phone:406-204-4407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016808207R00000X
MT12469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1548478555OtherNPI