Provider Demographics
NPI:1073937835
Name:SORENSEN, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2250 S WOODWORTH LOOP STE 101
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-7457
Mailing Address - Country:US
Mailing Address - Phone:907-745-7546
Mailing Address - Fax:907-745-7546
Practice Address - Street 1:2250 S WOODWORTH LOOP STE 101
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7457
Practice Address - Country:US
Practice Address - Phone:907-745-7546
Practice Address - Fax:907-745-7540
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-13
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK233008207ND0101X, 207N00000X
CAA162943207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology