Provider Demographics
NPI:1427086610
Name:PASTER, ROBERT ZORBA (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ZORBA
Last Name:PASTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-1003
Mailing Address - Country:US
Mailing Address - Phone:608-835-2222
Mailing Address - Fax:608-835-1090
Practice Address - Street 1:753 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-1003
Practice Address - Country:US
Practice Address - Phone:608-835-2222
Practice Address - Fax:608-835-1090
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19794-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1427086610Medicaid
WI30101100Medicaid
WI30101100Medicaid
WIB55611Medicare UPIN
WI015874150Medicare PIN